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December 23, 2015

Infrequently Asked Questions: Can you really lose weight through breastfeeding?

The world is full of questions we all want answers to but are either too embarrassed, time-crunched or intimidated to actually ask. In the spirit of that shared experience, we've embarked on a journey to answer all of the questions that burn in the minds of Philadelphians -- everything from universal curiosities (Why do disposable coffee cups still leak?) to Philly-specific musings (How does one clean the Liberty Bell?). 

For as long as there have been babies, there has been baby weight. And while elaborate diet and exercise gimmicks have come and gone through the years to shed the excess pounds, breastfeeding has recently emerged as a startlingly simple solution -- one that, on its face, seems just a little too good to be true.

Below, Dr. Lori Feldman-Winter, professor of pediatrics at Cooper Medical School of Rowan University, explains whether you really can lose weight through breastfeeding, and why the perks of exclusive breastfeeding extend well beyond vanity. 

There's a running idea right now that you can lose weight through breastfeeding. Is there any truth to that?

We know that breastfeeding in the first half of the first year of the baby’s life accounts for about 500 calories per day that are consumed, just in the production of milk. So, a mother who’s breastfeeding, particularly mothers exclusively breastfeeding -- all the nutrition a baby is getting is from the mother -- the mother is burning 500 excess calories per day. You would assume, given all the caloric expenditure, you would lose weight if you’re not making that up in eating. So that’s where research in the past has been somewhat muddy. There have been studies that have shown a decreased weight loss in the postpartum period for mothers breastfeeding, and some haven’t shown it. 

But I will tell you this is timely, because another study came out in November 2015 that controls for the intensity of breastfeeding; which, other studies may have lacked that element in that they just looked at any breastfeeding. And many mothers breastfeed but not exclusively, and the actual rates of exclusive breastfeeding are quite low. So in this study, they show that if a mother breastfeeds exclusively, she could achieve a little over 4 kilograms weight loss over that period of time. That’s 10 pounds. That is a study that controls for many of the other factors, including exercise and other conditions that would affect the mother's weight loss. So that’s encouraging ...

Is it acceptable to try to lose weight during that period?

There have definitely been studies looking at what is acceptable weight loss in the mothers. But in general, mothers can safely lose several kilos per month -- maybe five pounds per month, safely at that trajectory, without affecting the nutrition she delivered to the baby. In fact, there have been studies done in nutrition in poor areas around the world, places where food accessibility is particularly challenging and in conditions where mom’s nutrition is not so great, and what's been found is the nutritional value of human milk is preserved. So the body will waste away calories from the mother in order to sustain nutritional value of the milk. There’s no concern in terms of the safety of the baby not getting nutritionally adequate milk. It’s really hydration that’s more of an issue, in terms of making sufficient milk volume. But really, the caloric intake of the mother doesn’t relate to the nutritional value of her milk -- meaning they’d still have the same amount of calories and nutrients.

And so many moms come into pregnancy already overweight. We know from the prevalence of obesity in the United States that’s a huge problem. We can safely recommend postpartum that mothers do strive to lose weight at a normal trajectory, and these studies verify the fact that can be done through exclusive breastfeeding. 

Another interesting thing illustrated recently is this is not just about poundage and weight loss. As we know, excess weight is associated with disease ... [Mothers who already] have problems with gestational diabetes, those mothers, in fact, have a very high risk of developing full-blown Type 2 diabetes later on. And there was recently a study that was really exciting, because what’s been found is if a mother exclusively breastfeeds, she will essentially erase that risk of developing Type 2 diabetes after developing the baby. 

Mothers, we know, if they have gestational diabetes, that’s a red flag. That would make us worry about metabolism after. We can safely recommend exclusive breastfeeding as a way to offset that risk.

What is a word of caution you’d end with?

I would say that, unfortunately, in the United States babies often have something that leads to supplementation with a formula early on, even in the hospital, and that mothers should understand the risks of supplementation. That there are so many benefits and long-term benefits for the mother as well as the baby by exclusive breastfeeding that moms have to be their own and their baby’s advocate to try to maintain exclusive breastfeeding, and even if she might hear from her provider, or family members or someone else that ‘Oh, she should take a break – don’t worry, I’ll formulate the baby, don’t worry it’s just a little bit of formula,’ it really does make a difference. 

So, we really have a hard time and are striving to improve the exclusive breastfeeding rate in the United States. As it stands, only 40 percent of our population exclusively breastfeeds for three months, which is the timeframe talked about in the study. And at six months, which is what’s recommended by the American Academy of Pediatrics, only 18 or 19 percent of our babies in the U.S. are exclusively breastfeeding. So that’s less than one in five able to exclusively breastfeed for six months. So many things happen from the start, from delivery in the hospital to six months of life, that undermine support for exclusive breastfeeding. And weight loss is one factor impacted, but there are many factors impacted -- including health and wellness of the baby.

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