P11 - Barriers and enablers to breastfeeding for women who have a high body mass index: a mixed-methods study

Abstract

Despite the benefits of breastfeeding, women who have a high body mass index (BMI) are less likely to initiate breastfeeding and more likely to cease breastfeeding prior to six months postpartum than women with normal BMI. To investigate the barriers and enablers to breastfeeding for women with high BMI from the perspectives of women and midwives. Mixed-methods study. Women were recruited from a large public tertiary health service invited to compete a survey in the third trimester of pregnancy and six weeks post-partum about breastfeeding intentions, knowledge, barriers and enablers, and support needs and preferences. The surveys were available in English, Arabic, Chinese and Vietnamese. Midwives employed at the health service participated in a focus group about the breastfeeding information and support needs and preferences of women with a high BMI. 67 completed pregnancy and 50 postnatal surveys were received. There were no significant differences in infant feeding intentions, initiation and duration between women who had a high BMI and those who had a BMI in the normal range. Women with high BMI were more likely than women with normal BMI to report that paid employment was a barrier to breastfeeding (high BMI: 76.3% vs normal BMI: 50.0%, p=0.029) and breastfeeding was difficult (high BMI: 46.9% vs normal BMI: 10.0%; p=0.036), and less likely to be able to easily access breastfeeding support from healthcare professionals (high BMI: 72.4% vs normal BMI: 100%, p=0.029). Thirteen midwives participated in the focus group and reported that women with high BMI tended not have realistic expectations about breastfeeding and women (with both high and normal BMI) would benefit from further education and resources about breastfeeding. Women with high BMI would benefit from breastfeeding support and education which emphasises encouragement, reassurance and normalisation of breastfeeding for women with high BMI.