– MSc community medicine trainee, Post Graduate Institute of Medicine, Haputhale, Uva Province, Sri Lanka
Disclosure(s):
Neerodha K. Dharmasoma, MBBS: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: The double burden of malnutrition has been a vicious cycle of which culmination is really challenging. The larger proportion of malnutrition is taken over by obesity worldwide. Over and under nutrition are interrelated at deeper levels although seem like simply two different entities to address. Maternal obesity causes poor breast feeding which will lead to infant undernutrition and subsequent risk of obesity in later life(1–3). This review aims discovering the best available evidence on antenatal obesity resulting in delayed establishment, non-exclusive and early cessation of breast feeding.
Methods: Systematic reviews published between 2000 and December 2021 were searched for stronger evidence in PubMed and Google scholar with key words.
Results: Five systematic reviews(4–8) with evidence on obesity and breast feeding association were analyzed.
There were statistically significant associations (at 5% significance level) reported with delayed establishment, less intention and early cessation of breast feeding of their offspring in women with antenatal obesity in all five reviews. Delayed lactogenesis and reduced lactation were evident among obese(5–7). Obese women breast fed shorter duration than normal weight women even after correcting for possible confounders(8). And non-exclusive breast feeding was also identified as comparatively higher among obese (4). Results were in consistent with a dose-response meta-analysis (6).
The reasons identified varies i.e. physiological, behavioral, socio-cultural, psychological and medical (8). Obesity physiologically reduces lactogenesis (7,9). Large breasts may make latching on difficult (poor positioning and attachment) (8,10). Poor mental health, feeling uncomfortable at feeding in public or lack of confidence on body image can be the causes. And obese mothers are more prone to get delivery complications whose babies may end up in delayed initiation and non-exclusive breast feeding(10).
Conclusions: It is evident that the antenatal obesity is associated with sub-optimal breast-feeding practices which needs both medical and behavioral change interventions. The need of more qualitative studies for deeper understanding of maternal perceptions is underscored before planning interventions.
.png)
