Breastfeeding and Overweight/Obesity: The Leader's Role
College Station TX USA
From: LEAVEN, Vol. 43 No. 1, January-February-March 2007, p. 5
Concern about childhood overweight and obesity is increasing as the health risks of overweight become widely recognized. The incidence of overweight and obesity are increasing worldwide. As Dr. Soukup's article shows, breastfeeding is one factor shown by research to reduce the chances of childhood obesity.
Leaders can communicate these findings to mothers. We can also discuss nutritional concerns with mothers, from starting solids to nutrition for the older infant and the family. Research continues to confirm what La Leche League has always recommended: A diet for the whole family based on natural, unprocessed foods, while avoiding sugary and high-fat processed foods, promotes health in many ways. One way this diet promotes health is by reducing the risk of overweight and obesity (THE WOMANLY ART OF BREASTFEEDING 2004).
The World Health Organization (WHO) released new growth standards for children in April 2006. These new standards are superior because they are based on children's growth under optimal conditions. The breastfed baby was used as the standard for infant growth. These standards are intended to be useful for monitoring for obesity as well as undernutrition.
With the increased concern about childhood overweight, a mother of a larger-than-average breastfed baby may find that her health care professional is concerned about obesity. It is not currently known whether heavier breastfed babies are at higher risk of becoming overweight than slimmer breastfed babies; however, it is known that breastfed babies have a lower risk of later becoming overweight than formula-fed babies.
If a mother is being encouraged to restrict breastfeeding because her baby is "too big," we can encourage her to communicate with her health care professional about the research suggesting that breastfeeding protects against overweight and obesity. The LLLI pamphlet, Breastfeeding and Obesity, provides details about the complex causes and the risks of obesity. It reviews the evidence that breastfeeding reduces these risks, for both mother and baby. The pamphlet also makes it clear that breastfeeding can't be seen as a panacea, but as one aspect of the healthy lifestyle that protects against obesity.
The mother can also communicate the other benefits of breastfeeding and why breastfeeding is important to her and her baby. Although overweight is an important health issue, it is not the only health issue, and breastfeeding contributes to the baby's and mother's physical, cognitive, and emotional health, and to the mother-baby relationship.
The health care professional may not be aware that restricting breastfeeding is not as easy as it sounds. Shortening the length of breastfeeding sessions could prevent the baby from receiving enough hindmilk, which helps baby to be satisfied for longer (THE WOMANLY ART OF BREASTFEEDING 2004). Reducing the frequency of breastfeeding may not be feasible, especially if the mother does not schedule feedings, and if she nurses for comfort rather than just nutrition. Maintaining clear communication with the health care professional is important whenever a mother has concerns about what is being recommended.
In some cases, babies who grow very quickly are dealing with an oversupply of milk. If a mother calls with concerns that her baby is "too big," the Leader can ask whether the mother is seeing any signs of an overly abundant milk supply. The signs, in addition to the baby's quick weight gain, include a baby who is very fussy or colicky, chokes when the milk lets down, is fussy at the breast, goes on frequent nursing strikes, has explosive, green, frothy, bowel movements, spits up or has reflux, and a mother who has frequent plugged ducts and/or mastitis. If several of these signs are present, the Leader can give the mother information about dealing with oversupply. The oversupply FAQ section on the LLLI Web site (www.llli.org/FAQ/oversupply.htm) has recently been revised and is an excellent resource.
Vickers, M. Breastfeeding and Obesity. LLLI, September, 2006. Publication No. 1874-17.
THE WOMANLY ART OF BREASTFEEDING. Schaumburg, IL: LLLI, 2004; 205-220.
World Health Organization Releases New Child Growth Standards: Standards confirm that all children worldwide have the potential to grow the same. Media release from WHO, 2006. <http://www.who.int/mediacentre/news/releases/2006/pr21/en/index.html>.