Plus-sized Breastfeeding
By Laura Silvas, RN IBCLC
It's no secret that everyone's anatomy is different. Each breast, areola, and nipple have unique characteristics. Women labeled "plus-sized," or those with larger breasts often have concerns about their ability to breastfeed their babies. Some comments/concerns that I've heard:
Will I make too much milk because my breasts are so large?
Will I not make enough milk because my breasts have so much fatty tissue?
I'm worried about suffocating my baby.
I can't hold my baby and my breast simultaneously.
I can't find nursing clothes that fit my breasts.
A study published on the Maternal and Child Health Journal Website confirms that plus-sized women do indeed have these concerns. It states that "studies have shown that women with a BMI ≥ 30 kg/m2 lack confidence in their ability to reach breastfeeding goals, experience challenges with latching and positioning, find it difficult to find suitable clothing for breastfeeding, and have few friends or family members who have breastfed. Additionally, a recent review highlighted several mechanical (e.g., larger breasts), biological (e.g., delayed lactogenesis II), and psychosocial factors (e.g., low confidence, self-efficacy, body image) that may impede breastfeeding behaviors. However, we know very little about what can contribute to and support breastfeeding initiation and maintenance in women with a BMI ≥ 30 kg/m2."
Support
Mothers with higher BMIs may experience a "high risk" pregnancy and/or delivery. Pre-existing co-morbidities, along with new diagnoses in pregnancy such as hypertension, PCOS, diabetes (Type I, II, or GDM), Hypothyroidism, Pre-Eclampsia, etc., may add to the difficulty of carrying, delivering and feeding your baby. Working with your healthcare provider to stay on top of any developing diagnoses, medications, and a thorough plan of care throughout pregnancy and postpartum can help to ensure that you feel supported, educated, and encouraged.
Support groups for almost every topic exist now, thanks to the internet and social media. If you struggle as a plus-sized breastfeeding mom, reaching out to fellow mom groups may help you feel supported and make new friends. However, remember that not all advice is good advice. Tips are great, but remember, if you need medical guidance, reach out to your medical team.
Breast Size + Positioning
The size of your breasts, whether XL or XS, doesn't influence the amount of milk you make. Hormones are responsible for the creation and letdown of your milk, and this milk is produced in the alveoli of your breasts. Additionally, the size of your breasts doesn't determine the alveoli's ability to produce milk. So, the condensed answer is that the size of your breasts doesn't affect the amount of milk you will produce.
Some moms have voiced that they feel overwhelmed by the task of holding their tiny babe, positioning and massaging their breasts, and stimulating a sleepy baby all at the same time.
Here are some tips:
Elevate the breast: a rolled-up towel/washcloth, a scarf, or a pillow under the breast can help to support larger breasts, so you don't have to "hold" them.
Don't be afraid to try new positions: football, side-lying, relaxed, or reclined positions are a bit easier with large breasts.
Use hand positions such as sandwich, dancer, or scissor holds.
Find a pillow or support. Remember, it doesn't have to wrap around you to help support the session.
One complaint I hear frequently is that the breast tissue smothers or covers the baby's nostrils while feeding. This will likely cause the infant to unlatch so that they can breathe. To help your baby latch comfortably, press the breast tissue down around their nostrils without pulling the areola or nipple out of the baby's mouth. Listen for their suck pattern, breathing, and color to ensure proper oxygenation.
Nutrition + Weight Loss
Maintaining a healthy diet while breastfeeding is just as important as when you are pregnant. While some women lose weight while breastfeeding, some don't. Regardless, filling your body with various healthy choices ensures that you and your baby are adequately cared for. Women need an extra 500 extra calories a day while breastfeeding. That may not be true for someone with a higher BMI. But, working hand in hand with your health care provider and dietician can ensure a plan of care tailored to your needs. Another great resource is the DRI Calculator to help you work out how many calories you should be getting in based on your BMI.
Clothes
Finding a supportive nursing bra is essential for every nursing mama. Unfortunately, sometimes it isn't always easy to find in larger sizes. Avoid sports and "regular" bras, as these can occlude the breast and milk ducts. Many online sites now offer a variety of bras, tanks, swimsuits, and tops to ensure mamas have what they need in the size they need. I suggest using a measuring tape and checking your size charts so that you can choose clothes that fit you comfortably.
Conclusion
Breastfeeding can be challenging; unfortunately, our bodies sometimes don't make it easier for us. If you are thinking of breastfeeding, are currently breastfeeding, or need support, contact us here at Leva; we would love to help you and your baby.
