Interventions to increase the duration of breastfeeding in obese mothers: the Bassett Improving Breastfeeding Study.
OBJECTIVE
Maternal obesity is associated with poor breastfeeding outcomes, yet no intervention has been developed to improve them. To ascertain whether increased breastfeeding support or provision of a breast pump is a feasible, effective intervention to improve breastfeeding, we enrolled obese women who intended to breastfeed in two randomized trials.


METHODS
In Bassett Improving Breastfeeding Study (BIBS) 1, 40 women received targeted breastfeeding support in the hospital and via telephone or usual care. Information regarding breastfeeding was collected via telephone for 7 days after delivery and at 30 and 90 days postpartum. In BIBS 2, 34 obese mothers received a manual or electric breast pump to use for 10-14 days or no pump; data collection was similar.


RESULTS
In both experiments, randomization failed to distribute women of differing postpartum body mass index adequately among the treatment groups. When analyses were adjusted for this, there was no difference in BIBS 1 between targeted and usual care groups and in BIBS 2 among the treatment groups in the proportion of women still breastfeeding at the times studied.


CONCLUSIONS
In future studies of obese women, stratified randomization may be necessary. Further development of interventions to help obese women achieve optimal breastfeeding outcomes is required.
Division of Nutritional Sciences, Cornell University, Ithaca, New York 14853, USA. kathleen.rasmussen@cornell.edu
Kathleen M
KM
Rasmussen
Christine M
CM
Dieterich
Sarah T
ST
Zelek
Jaime D
JD
Altabet
Chris L
CL
Kjolhede
D015992:Body Mass Index; D001942:Breast Feeding / Q000453:epidemiology / Q000523:psychology; D003625:Data Collection; D037001:Directive Counseling; D004864:Equipment and Supplies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D009765:Obesity / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D011181:Postnatal Care / Q000379:methods / Q000458:organization & administration; D049590:Postpartum Period; D011247:Pregnancy; D015397:Program Evaluation; D011644:Puerperal Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012944:Social Support; D013997:Time Factors; D016896:Treatment Outcome