The relationship between breastfeeding and postpartum weight change—a systematic review and critical evaluation

• Published in: International Journal of Obesity Vol. 38; no. 4; pp. 577 - 590
• Main Authors: Neville, C E, McKinley, M C, Holmes, V A, Spence, D, Woodside, J V
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2014; Nature Publishing Group
• Subjects: 692/699/2743/393; 692/700/2817; Biological and medical sciences; Body composition; Body fat; Body Mass Index; Body size; Body Weight; Body weight loss; Breast Feeding; Breastfeeding & lactation; Epidemiology; Female; Health Promotion and Disease Prevention; Humans; Internal Medicine; Literature reviews; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Mothers; Obesity; Obesity - prevention & control; Observational studies; Physiological aspects; Physiological research; Postpartum; Postpartum Period; Pregnancy; Public Health; Retention; review; Reviews; Subgroups; Systematic review; Time measurement; Weight control; Weight Loss; Women's Health; weight management; postpartum; body composition; breastfeeding; Evaluation; Obesity; Nutrition; Body weight; Nutrition disorder; Weight loss; Variations; Metabolic diseases; Systematic review; Corporal biometry; Breast feeding; Puerperium; Body composition; Nutritional status
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2013.132

Pregnancy and the postpartum period is a time of increased vulnerability for retention of excess body fat in women. Breastfeeding (BF) has been shown to have many health benefits for both mother and baby; however, its role in postpartum weight management is unclear. Our aim was to systematically review and critically appraise the literature published to date in relation to the impact of BF on postpartum weight change, weight retention and maternal body composition. Electronic literature searches were carried out using MEDLINE, EMBASE, PubMed, Web of Science, BIOSIS, CINAHL and British Nursing Index. The search covered publications up to 12 June 2012 and included observational studies (prospective and retrospective) carried out in BF mothers (either exclusively or as a subgroup), who were ⩽2 years postpartum and with a body mass index (BMI) >18.5 kg m –2 , with an outcome measure of change in weight (including weight retention) and/or body composition. Thirty-seven prospective studies and eight retrospective studies were identified that met the selection criteria; studies were stratified according to study design and outcome measure. Overall, studies were heterogeneous, particularly in relation to sample size, measurement time points and in the classification of BF and postpartum weight change. The majority of studies reported little or no association between BF and weight change ( n =27, 63%) or change in body composition ( n =16, 89%), although this seemed to depend on the measurement time points and BF intensity. However, of the five studies that were considered to be of high methodological quality, four studies demonstrated a positive association between BF and weight change. This systematic review highlights the difficulties of examining the association between BF and weight management in observational research. Although the available evidence challenges the widely held belief that BF promotes weight loss, more robust studies are needed to reliably assess the impact of BF on postpartum weight management.