Maternal obesity and breastfeeding: retrospective longitudinal observational study

Objective. Evaluation of the relationship between maternal obesity and the onset and duration of breastfeeding.
Materials and Methods. This is a retrospective longitudinal observational study, including puerperas, who delivered a single fetus at term at the Obstetric Unit of Modena from 1 April 2020 to 30 April 2021, who completed the questionnaire “Madri” offered by MAMI (Italian maternal breastfeeding movement).
Results. 366/452 (81%) patients accepted to answer the questionnaire by telephone. Among these, 42.6% (n = 156) were obese at the time of delivery and 26% of them said they hadn’t had the milky whip. Moreover, compared to normal weight women, the less obese had a physiological milky whip (between 48-72 hours after childbirth), (155, 74% vs 72, 46% p = 0.000) and were exclusively breastfeeding during hospitalization (155, 74% vs 81, 52% p = 0.001). The exclusive lactation rates at one week, one month and three months from childbirth are in Figure 1. After three months, the main reasons for withdrawal from breastfeeding were: the mothers’ perception of having little milk for 30% of normal weight and 38% of obese women, maternal choice, 25% and 29% respectively, and breast rejection by the child, 22% and 18% respectively.
Conclusions. Maternal obesity seems to be associated with a more common failure to start breastfeeding, a shorter duration, less adequate milk production and a delayed onset of lactogenesis, compared to normal weight women. This suggests that healthcare professionals should consider obese women at risk of unsuccessful breastfeeding, and therefore follow-up strategies should be implemented in this population.