The perceptions and experiences of women with a body mass index ≥ 30 kg m² who breastfeed: A meta‐synthesis

Abstract

Breastfeeding has copious health benefits for both mother and child, but rates of initiation and maintenance among women with a body mass index (BMI) ≥ 30 kg m 2 are low. Few interventions aiming to increase these rates have been successful, suggesting that breastfeeding behaviour in this group is not fully understood. Therefore, this review aimed to systematically identify and synthesise the qualitative literature that explored the perceptions and experiences of women with a BMI ≥ 30 kg m 2 who breastfed. The search identified five eligible papers, and a meta‐ethnographic approach was taken to synthesise the findings. One theme was identified: “weight amplifies breastfeeding difficulties,” revealing that women with a BMI ≥ 30 kg m 2 experience common breastfeeding difficulties to a greater degree. In particular, women with a BMI ≥ 30 kg m 2 struggle with the impact of medical intervention, doubt their ability to breastfeed, and need additional support. These findings can inform understanding of breastfeeding models, future research directions, intervention development, and antenatal and post‐natal care for women with a BMI ≥ 30 kg m 2 .

Exploring Successful Breastfeeding Behaviors Among Women Who Have High Body Mass Indices

“…To improve breastfeeding, we need to focus on targeting theoretically sound and evidence-based factors using best-practice complex intervention design. The evidence supports the capability of women to engage in breastfeeding being positively underpinned by knowledge, women in particular recognizing the health benefits for optimal child nutrition and health outcomes ( Lyons, Currie & Peters, 2019 ). The importance of partners in supporting women to engage in breastfeeding is also acknowledged in previous work.…”

“…Systematic reviews have highlighted that the barriers and enablers to breastfeeding for women with high BMIs were similar to other women, but that the extent of the experience may be more problematic for women with higher BMIs because of their weight status ( Chang et al, 2020 ; Lyons, Currie & Smith, 2019 ; Lyons, Currie & Peters, 2019 ). The physicality of breastfeeding and the stigma and social bias associated with high BMIs were pronounced findings in our results, which aligns with previous work ( Incollingo Rodriguez et al, 2020 ; Lyons, Currie & Smith, 2019 ). Our findings also demonstrated that, when participants with high BMIs were provided with the right support, in a way that is acceptable to them, they breastfeed for extended periods.…”

“…The inclusion of a support partner in future antenatal breastfeeding interventions is essential to the building of social support and increasing a woman’s motivation to engage in the behavior. Another important ingredient in antenatal breastfeeding interventions is resourcing HCP services so that specific and tailored support can be provided ( Balogun et al, 2016 ; Lyons, Currie & Peters, 2019 ). The failure to build additional resources into an intervention will result in diminished effects, a lack of sustainability in the intervention over time, and potentially a widening of the gap in breastfeeding rates between women with higher and lower BMIs.…”

The Sexual and Reproductive Health needs and preferences of youths in sub-Saharan Africa: A meta-synthesis

“…Consequently, this approach enabled synthesis of youth's SRH needs and preferences across individual papers with greater explanatory power than narrative or thematic approaches [49,50]. Its analytical nature and widespread use in non-ethnographies underscore its value [51][52][53][54].…”

Is Maternal Body Weight or Composition Associated with Onset of Lactogenesis II, Human Milk Production, or Infant Consumption of Mother’s Own Milk? A Systematic Review and Meta-Analysis

“…Mothers with underweight as well as those with overweight/obesity experience higher rates of preterm birth, which itself is associated with delayed lactogenesis II, decreased expressed milk volumes, and early cessation, due to a variety of factors associated with preterm birth including early separation, maternal illness, and immature mammary glands [ 8 , 9 ]. Potential mechanisms underlying the relationship between overweight or obesity and lactation performance may include hormonal and metabolic alterations [ [10] , [11] , [12] , [13] ]. Specifically, prolactin and insulin may play a role.…”