Brown, A., Rance, J., & Warren, L. (2015). Body image concerns during pregnancy are associated with a shorter breast feeding duration. Midwifery, 31(1), 80-89.
Why do the research?
There are lots of studies showing that body image related concerns such as feelings of embarrassment about breastfeeding or worrying about the impact of breastfeeding upon breast shape and size can stop women from breastfeeding, or mean they stop after only a short time.
The majority of these studies look at women after birth and consider body image related predominantly to the breasts, rather than wider body image. We also know that women who are obese are less likely to breastfeed but weight is different to body image; women who are obese can have a positive body image, whilst women who are a healthy weight can have lots of concerns.
Understanding wider body image issues, and exploring them in pregnancy where there is still time to intervene and support women, is important in understanding how body iamge affects breastfeeding.
Who took part?
One hundred and twenty eight women took part during pregnancy and when their baby was six months old.
What did they do?
During pregnancy they completed a questionnaire exploring their height and weight before pregnancy and body image in relation to their changing pregnancy shape, concerns for their body after birth and whether they were trying to control their weight during pregnancy. They also indicated whether they planned to breastfeed and for how long.
At six months after birth they completed a questionnaire examining whether they breastfed at birth and if relevant how long they breastfed for. If they had stopped breastfeeding they answered questions exploring why.
What did it find?
Body image concerns were high during pregnancy with over half of women worried about their changing shape and how their body would look after pregnancy.
Women who had more concerns during pregnancy were less likely to plan to breastfeed at all and if they did breastfeed, breastfed for a shorter time than those with fewer concerns.
Among those who had stopped breastfeeding before six months, those who had higher body image concerns during pregnancy were more likely to have stopped because they felt embarrassed by breastfeeding or were worried about its impact on the shape of their breasts.
Interestingly, all the relationships above were nothing to do with actual weight, rather concerns about the body. Women could be a healthy BMI and still have high concerns.
What does this mean?
Body image concerns outside of pregnancy are so common they are considered normal. But until fairly recently, pregnancy was seen as a time to relax the diet and ‘eat for two’. This wasn’t healthy, but we seem to have moved too far in the other direction. Celebrity stories about weight loss and the perfect pregnancy bump are everywhere and women are feeling increasing pressure to look a certain way during pregnancy.
The findings clearly show that women are being affected by body image concerns, with an impact not just on their wellbeing during pregnancy but on how their baby is fed. This is not just linked to weight, women with healthy weights have high concerns.
There are lots of myths that you can’t diet or lose weight whilst breastfeeding (untrue – and anyway, breastfeeding burns up to 500 calories a day – equivalent to a 5 mile run!) or that breastfeeding ruins the shape of your breasts (again untrue – research has shown that its pregnancy that causes any breast changes, not breastfeeding). Higher body image concerns may also make mums feel more self-conscious feeding in front of others.
We need more positive images of normal pregnancy and breastfeeding and more education as to how breastfeeding in fact helps you get back into shape rather than damaging your figure. Although most of all we need society as a whole to quit with this pressure on women to look a certain way, particularly during one of the most important times of their life.
You can download a copy of the paper here: Body image during pregnancy and breastfeeding duration