Reducing postpartum weight retention and improving breastfeeding outcomes in overweight women: a pilot randomised controlled trial.

Julia Martin,Alexis Hure,Lesley Macdonald-Wicks,Clare Collins,Roger Smith

doi:10.3390/nu7031464

Abstract

Overweight and obesity is prevalent among women of reproductive age (42% BMI > 25 kg/m2) and parity is associated with risk of weight gain. Weight gain greater than that recommended by the Institute of Medicine (IOM )is also associated with lower rates of breastfeeding initiation and duration in women. The aim of this pilot randomised controlled trial is to examine the feasibility of recruiting and maintaining a cohort of pregnant women with the view of reducing postpartum weight retention and improving breastfeeding outcomes. Women (BMI of 25–35 kg/m2 (n = 36)) were recruited from the John Hunter Hospital antenatal clinic in New South Wales, Australia. Participants were stratified by BMI and randomised to one of three groups with follow-up to six months postpartum. Women received a dietary intervention with or without breastfeeding support from a lactation consultant, or were assigned to a wait-list control group where the dietary intervention was issued at three months postpartum. Feasibility and acceptability was assessed by participation rates and questionnaire. Analysis of variance and covariance was conducted to determine any differences between groups. Sixty-nine per cent of the participants were still enrolled at six months postpartum. This pilot demonstrated some difficulties in recruiting women from antenatal clinics and retaining them in the trial. Although underpowered; the results on weight; biomarkers and breastfeeding outcomes indicated improved metabolic health.

Highlights

IntroductionOverweight and obesity is prevalent among women of reproductive age (25–34 years) with 42%
Overweight and obesity is prevalent among women of reproductive age (25–34 years) with 42%having a BMI > 25 kg/m2 [1]
Two of the participants suggested they would prefer face-to-face contact with a dietitian (n = 2) during the program. This pilot Randomised Controlled Trials (RCTs) examined the feasibility of a program that included dietary intervention and breastfeeding support for overweight and obese pregnant women, with the aim of reducing postpartum weight retention and enhancing rates of breastfeeding

Summary

Introduction

Overweight and obesity is prevalent among women of reproductive age (25–34 years) with 42%. Having a BMI > 25 kg/m2 [1]. Having children is associated with maternal weight gain, in the long-term [2]. Weight gain increases the risk of developing diabetes and heart disease [8,9]. The amount of weight retained after pregnancy can shift women from the healthy weight category into the overweight or obese BMI categories. Starting the pregnancy at a higher weight increases the risk for poor pregnancy outcomes [9,10], such as gestational diabetes (RR = 2.09 for BMI > 30 kg/m2) [11], delivery intervention [10], macrosomia

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