1 Division of Nutritional Sciences, Cornell University , Ithaca, New York.
Breastfeed Med. 2014 Dec;9(10):503-9. doi: 10.1089/bfm.2014.0104.
Obese women are at high risk of early breastfeeding cessation, and health professionals (HPs) have a unique opportunity to provide them with breastfeeding support. Our objective was to describe HPs' experiences providing breastfeeding care for obese women during the prenatal, peripartum, and postpartum periods.
In-depth, qualitative interviews were conducted with 34 HPs (including obstetricians, midwives, pediatricians, nurses, and lactation consultants) who care for pregnant or lactating women. They were recruited from a variety of settings in central New York. Interviews were audio-recorded, transcribed, verified for accuracy, and then analyzed qualitatively.
HPs identified obesity in multiple ways, some of which were consistent with standard cutoffs, whereas others implied extreme obesity. Nearly all HPs discussed ways they perceive obese women have challenges with breastfeeding. Some HPs described challenges as specific to obese women (e.g., limited mobility), whereas others described challenges as universal but more likely to occur among obese women (e.g., difficulties positioning the infant to breastfeed). Across professions, HPs described providing breastfeeding care for obese women as requiring more time and physical work and as being more challenging. HPs acknowledged stigma around obesity and discussed treating obese women with dignity and the same as other women. Strategies were suggested for improving breastfeeding support for obese women.
HPs identified multiple challenges that obese women encounter with breastfeeding, as well as their own challenges with providing care. Comprehensive strategies are needed to assist obese women with breastfeeding and to alleviate strain on HPs who provide their care.
肥胖女性母乳喂养早期中断的风险较高，而健康专业人员（HPs）有机会为她们提供母乳喂养支持。我们的目的是描述 HPs 在产前、围产期和产后阶段为肥胖女性提供母乳喂养护理的经验。
对 34 名 HPs（包括产科医生、助产士、儿科医生、护士和哺乳顾问）进行了深入的定性访谈，他们负责照顾孕妇或哺乳期妇女。他们是从纽约州中部的各种环境中招募的。访谈进行了录音、转录、准确性验证，然后进行定性分析。
HPs 通过多种方式识别肥胖，其中一些与标准截止值一致，而另一些则暗示极度肥胖。几乎所有的 HPs 都讨论了他们认为肥胖女性在母乳喂养方面存在挑战的方式。一些 HPs 将挑战描述为特定于肥胖女性（例如，行动不便），而另一些 HPs 将挑战描述为普遍存在但更可能发生在肥胖女性身上（例如，婴儿哺乳定位困难）。跨专业，HPs 将为肥胖女性提供母乳喂养护理描述为需要更多的时间和体力劳动，并且更具挑战性。HPs 承认肥胖相关的耻辱感，并讨论了以尊严和与其他女性相同的方式对待肥胖女性。还提出了改善肥胖女性母乳喂养支持的策略。
HPs 确定了肥胖女性在母乳喂养方面遇到的多种挑战，以及他们在提供护理方面遇到的自身挑战。需要综合策略来帮助肥胖女性进行母乳喂养，并减轻为她们提供护理的 HPs 的压力。
