Enabling Breastfeeding for Women with Obesity

Purpose of Review This narrative review summarizes the epidemiology of breastfeeding outcomes by BMI category, describes research that elucidates underlying mechanisms, critically appraises intervention studies aimed at improving breastfeeding outcomes for lactating parents with obesity, and provides clinical management considerations. Recent Findings Exclusive breastfeeding for the first 6 months, with continued breastfeeding for at least 1 to 2 years, is strongly endorsed by many public health and professional organizations. Over 80% of parents in the USA initiate breastfeeding. While breastfeeding initiation rates are similar across body mass index (BMI) categories, lactating parents with obesity begin formula supplementation earlier and stop breastfeeding sooner than lactating parents without obesity. Weight stigma, lack of breastfeeding support tailored to larger bodies, and increased prevalence of birth complications, insulin resistance, and inflammation are proposed contributors to difficulties in establishing and sustaining breastfeeding. Summary Holistic, non-stigmatizing support for birthing people with obesity can enable them to have a satisfying breastfeeding experience.