Interventions to improve breastfeeding among obese women

Abstract

Maternal obesity is associated with poor breastfeeding (BF) outcomes, yet no intervention has been developed to improve them. To ascertain whether increased BF support or provision of a breast pump is a feasible, effective intervention to improve BF, we enrolled obese women who intended to breastfeed in 2 randomized trials. In Bassett Improving Breastfeeding Study (BIBS) 1, 40 women received targeted BF support in the hospital and via telephone or usual care. Information regarding BF was collected via telephone for 7 d after delivery and at 30 d and 3 mo postpartum. In BIBS 2, 34 obese mothers received a manual or electric breast pump to use for 10 d or no pump; data collection was similar. In BIBS 1, targeted care did not improve any measure of BF outcome. At 3 mo, fewer women in the targeted‐care group were still BF exclusively (P=0.03), and overall exclusive BF duration was 4.7 weeks shorter (P=0.03) than in the usual‐care group. In BIBS 2, provision of a breast pump did not improve any measure of BF outcome. At both 30 d and 3 mo, fewer women who received a pump were still BF (P<0.05) than those who did not. Execution of these studies was compromised by protocol violations, but regression analyses that accounted for these factors did not change the results. Further development of interventions of help obese women achieve optimal BF outcomes is required. (Funded in part by USDA/Hatch grant NYC‐399430; electric pumps donated by Medela.)