Pre-pregnancy Weight and Lactation: The Unseen Link

Introduction

Pregnancy and childbirth bring about numerous physiological changes in a woman's body, including the ability to produce milk for newborn. While lactation is natural, it can be influenced by various factors, including a woman's pre-pregnancy weight.

Breastfeeding can keep children healthy by protecting them from getting sick and preventing them from becoming overweight. The WHO says babies should only drink breastmilk until six months old. The parents can start giving other foods and breastmilk until the baby is two years old.

Women who are overweight or have a high BMI may have trouble initiating breastfeeding to the babies soon after giving birth. Being obese could make it harder to breastfeed for a long time. Research has found that women who are underweight or overweight before getting pregnant are less likely to start or continue breastfeeding their babies for as long as they should.

How Does Pre-pregnancy Overweight and Obesity Affect Lactation?

Various studies have determined how the mother's pre-pregnancy weight affects lactation success.

• One study found that moms who are very overweight tend to breastfeed for a shorter time than healthy moms. They also may stop breastfeeding entirely after two months of having a baby.

• When a pregnant mother is very overweight, it can cause problems for the baby when it is born. These problems include being born too early and needing a C-section delivery. These things can also make it harder for the mother to breastfeed successfully. Women who are very overweight may have difficulties continuing to breastfeed because they might have a lower socioeconomic status or education than others.

What Causes Lower Breastfeeding Rates in Obese Women?

The precise mechanisms underlying the lower breastfeeding rates in obese women are not yet fully understood, but several factors that contribute are listed below.

• Hormonal Imbalances: Excessive adipose tissue (body fat) in overweight or obese women can lead to hormonal imbalances. Hormones like prolactin and oxytocin play a crucial role in lactation, including milk production and letdown. Disruptions in hormonal regulation can affect the initiation and maintenance of lactation.

• Insulin Resistance: Obesity is commonly associated with insulin resistance. High insulin levels can disrupt the hormonal signaling pathways responsible for milk production. This interference can reduce milk volume and quality, leading to suboptimal lactation outcomes.

• Mammary Gland Development: Adequate development of the mammary glands during pregnancy is essential for successful lactation. Obesity may interfere with this process due to inflammation and altered mammary gland structure. These changes can impair milk synthesis and secretion, affecting milk production.

• Delayed Lactogenesis: Lactogenesis means when the breasts start making milk after having a baby. Women carrying extra weight may take longer to produce milk after giving birth. This delay may be caused by problems with hormones, not developing the breast fully, or health issues related to being too heavy.

• Milk Supply: Women with higher pre-pregnancy weight may face challenges related to milk supply. Some studies have suggested a potential for increased milk production in overweight women. Others have indicated that overweight and obese women may have difficulties with milk production, potentially leading to insufficient lactation.

• Breastfeeding Difficulties: Pre-pregnancy weight can affect breastfeeding mechanics and positioning. Excess body weight can make it more challenging for the baby to achieve a proper latch and for the mother to find comfortable breastfeeding positions. This can contribute to breastfeeding difficulties and impact lactation success.

How Does Pre-pregnancy Underweight Affect Lactation?

Studies regarding the connection between pre-pregnancy underweight and lactation are mostly inconclusive, with mixed results.

• Although there are not many studies about it, maternal underweight before pregnancy is also known to hurt breastfeeding duration.

• Underweight women are more likely to stop breastfeeding two, four, and six months after giving birth compared to women who are not underweight. This is different from the effect of being very overweight.

• One study by Zhu and other researchers found that being underweight before pregnancy makes it more likely moms will stop breastfeeding within two months after giving birth. Another study by Giovannini et al. concluded no connection between being underweight and how long a baby is breastfed.

• Another study discovered that women who were underweight before getting pregnant were less likely to plan to breastfeed and start breastfeeding. Right now, it is not clear whether moms who were underweight before getting pregnant breastfeed for a longer time or not.

What Causes Lower Breastfeeding Rates in Skinny Women?

• Many different things can affect whether or not an underweight woman decides to breastfeed baby.

• One possible reason why some underweight women may not breastfeed their babies as much is because of these different factors. Women who are too skinny may have some traits that make it difficult for them to keep breastfeeding.

• In a research, it was found that 62.4 percent of thin women with their first child were more likely to breastfeed. Women with more than one child may have more knowledge and experience regarding breastfeeding, and having multiple children might also help with breastfeeding. But when observed in groups of people with different numbers of children, it was still seen that being underweight was a problem. This could mean other factors causing this issue have not been measured yet.

• Babies born to skinny women may have a greater chance of being born small and having problems. These babies have a higher risk of being separated from their mothers after birth and not being breastfed for very long. This can happen more often when the mother is underweight and the baby is born small. It can cause the mother to stop breastfeeding early.

What Can Be Done to Improve Breastfeeding in Overweight and Underweight Women?

• The current breastfeeding rates worldwide are insufficient; therefore, the significant benefits of breastfeeding on the health of both mothers and children should be emphasized in all healthcare settings. All pregnant ladies should know the long-term impact of low breastfeeding rates.

• Encouraging women who plan to have babies to achieve a healthy weight before getting pregnant can help them breastfeed their babies long after birth. This is especially important for women who are too thin.

• Maternal undernutrition and obesity remain significant global health issues among women in their reproductive years. The nutritional status before conception should be analyzed and improved.

• Additional support and specialized assistance may be necessary for underweight and obese mothers to promote the successful initiation and continuation of breastfeeding.

Conclusion

Pre-pregnancy weight has been found to influence lactation outcomes. Maintaining a healthy weight before conception, addressing undernutrition and obesity, and providing targeted support can improve breastfeeding rates and long-term health benefits for mothers and children. Healthcare providers play a vital role in promoting optimal lactation outcomes. Healthcare providers should help pregnant women with the best ways to breastfeed and give them advice and support. By focusing on a woman's health before pregnancy and providing good care during pregnancy, doctors and nurses can help women breastfeed successfully and keep both the mother and baby healthy.