Older Age, Extra Pounds? Don’t Give Up On Breastfeeding

by Heidi Green
September 07, 2010

If you’re an expectant mother planning to breastfeed your baby, you may have been concerned by recent headlines that older mothers, or those with “extra pounds,” have more difficulty producing breast milk. Fortunately, that’s not the whole story. More importantly, there are things that you can do to help make sure breastfeeding gets off to a good start.

Research
In conducting their study, researchers at the University of California Davis Medical Center in Sacramento, California looked at factors associated with delays in mothers’ breast milk production. Particularly, they wanted to know which factors increased mothers’ risk for low milk supply at 72 hours after birth. They interviewed study participants during pregnancy and again after birth, on day three, and on day seven. They also consulted the mothers’ and babies’ medical records. Researchers focused on first-time mothers, particularly those who were markedly overweight, since they are more likely to experience delays in milk production.

Results
The good news is that nearly all (98 percent) of the 431 mothers in this study had adequate milk production by the end of the first week. Mothers whose milk supply is delayed beyond the first three days will still “do just fine,” reassures study lead Dr. Laurie A. Nommsen-Rivers. “Failure to ever achieve onset of copious milk production [is] rare,” she explains, “[occurring in] less than 2 percent of breastfeeding women by the end of the first week postpartum.”

However, a whopping 44 percent of study participants experienced a delay in their milk production beyond three days. While “reports from other settings around the world indicate that most breastfeeding mothers experience the onset of copious milk production within 1 to 2 days of giving birth,” Dr. Nommsen-Rivers states, “[this study] suggests that the onset of copious milk production is often delayed until 4 to 6 days after giving birth for first-time mothers here in the U.S.”

In addition, mothers who were overweight or obese were found to be at the greatest risk for delay (45 percent and 54 percent, respectively, compared to 31 percent for leaner mothers). Similarly, 58 percent of women older than 30 appeared to be at increased risk for delay, compared to 39 percent of those younger than 30.

The study found that feeding “well” during the first 24 hours of their newborns’ life helped increase mothers’ milk supply. Those participants who said they had “breastfed well” at least twice during the first 24 hours after delivery (39-43 percent) were less likely to have a delay in production compared to  those who said their babies fed well only once or not at all (65 percent).

Recommendations
Dr. Nommsen-Rivers and her study colleagues conclude that, despite challenges, older mothers or those who are obese or overweight should not give up on breastfeeding. Here are some tips for new mothers to encourage breastfeeding success:

• Embrace skin-to-skin contact. Studies show that skin-to-skin contact, especially within the first 1 to 2 hours after birth but also thereafter, is good for mothers and babies. An added benefit is that it provides lots of opportunity for your baby to breastfeed.

• Feed early, feed often. Breastfeeding truly is a supply-and-demand process. To encourage early development of a good supply, Dr. Nommsen-Rivers encourages mothers to put their babies to breast anytime there are signs of “interest,” rather than waiting for late signs of hunger such as crying. Is your baby smacking his lips or sucking on his fingers? Try to breastfeed.

• Keep baby close. New mothers should be encouraged to keep their newborns “within arms’ reach at least through the maternity hospital stay,” Dr. Nommsen-Rivers explains, “in order to avoid formula supplements, facilitate frequent breastfeeding, and ensure thorough emptying of their breasts.” These factors seem to encourage earlier achievement of full milk production.

• Seek help for breastfeeding difficulties. Lactation consultants may be available at the hospital where you give birth, at your local WIC office, or in your community. The International Lactation Consultant Association (ILCA) offers an online directory. A national breastfeeding help line is also available. You may even consider seeking out lactation care in advance. Try to choose a care provider with an affiliation with a lactation consultant. If possible, a visit from a lactation consultant within the first days after the baby’s birth can help identify and address any breastfeeding difficulties.

• Watch your baby’s weight. A delay in milk production puts your baby at higher risk of excessive weight loss. If you feel your milk supply hasn’t increased significantly within three days, you should talk with your baby’s health care provider about ways to ensure your baby receives enough nutrition while you increase your supply.