Full fat milk

It’s no surprise that with the Obesity Pandemic FAT RAMPAGE headlines still dominating any ‘health’ or ‘parenting’ media, there are a lot of (often unfounded) fears and prejudices about fat pregnancies, fat births and fat mothering out there. (Did you know that some doctors even worry about fat vaginas? Neither did I until I read this. Never thought you’d hear the term ‘fat vagina’ used as pseudo-medical jargon? Neither did I. Am I repeating the term ‘fat vagina’ gratuitously at this point? Yes, dear reader, perhaps I am.)

When I was pregnant with my daughter, I was lucky to find an obstetrician who never even weighed me and who never made assumptions about my health status because of my body size: many women don’t have that luxury. It is not unusual for women in regional or outer suburban areas to be refused obstetric treatment at their local hospital on the grounds of fat vagina high BMI, even if it is not their first birth and they have not shown any other indications of elevated risk.

It is also not unusual, once the baby is born, for fat women to receive negative or conflicting advice about breastfeeding.

Not many books will tell you that feeding with large breasts can be a bit tricky, logistically, but it can. And of course, larger women women are more likely to have large breasts. Large breasts don’t always behave: before babies’ necks are able to support the weight of their head, it really helps to have a nipple kept in a pretty steady position, and this is harder when your breasts want to wibble wildly about like nobody’s business. Sometimes women with large breasts have trouble seeing what they are doing with attachment, and that can make it harder to get things right to begin with, especially if they have a baby who has a funny way of holding her lip, like Bean had. Adding to this, the societal pressure to be discreet falls more heavily on women with more flesh to hide, particularly larger areola. Sometimes the omgsexyflesh effect of voluptuous breasts is not a positive experience, like when you’re trying to breastfeed in front of your brother-in-law, for instance. There are also many physiological reasons why a breastfeeding relationship might be a little trickier to establish for a fat mother – fat women are often subjected to more routine interventions during childbirth, some of which can interfere with lactation. Fat women also quite commonly have polycystic ovarian syndrome, or perhaps another hormonal quirk which may impact upon milk production.

As The Well-Rounded Mama highlights in her excellent piece on this topic, there are also psycho-social reasons why breastfeeding may be a little trickier for fat mothers. Reasons that researchers haven’t seemed overly interested in exploring.

I have said here that giving birth to Bean was a huge boost to my body-confidence. (For another take on a similar theme, see first the egg.) For most of my life, my body has been perceived by others – and of course by myself – as more imperfect and defective than useful and productive. My body has, in short, been burdened with an inferiority complex. It’s not just me who feels this way (nor just fat women, but of course fat is my focus in this post.) Is it any wonder that fat mothers, who’ve been led to believe by the media and wider society that their bodies are all wrong, fear that they will also fail to nourish their babies? Is it any wonder that fat mothers, who have probably already been subjected to greater scrutiny of their health and their behaviours and perhaps to a very medicalised pregancy and birth because of the size of their bodies find it difficult, then, to have trust in what their bodies can do? Is it any wonder that fat mothers, living in a culture where the Gisele Bundchens and Angelina Jolies set the bar for maternal aesthetics struggle even more than most to engage in an activity where their body will be exposed, where they may need to lift their shirt and show a flabby, stretch-marked belly in public? Is it any wonder that when it comes to breastfeeding rates, fat women – women who are most susceptible to messages undermining their confidence in normal physiological processes – are falling behind?

If breastfeeding is to take its rightful place at the centre of public health policies, we need to do more than name and shame groups of women who find it harder than others to feed their babies the physiologically normal way. We need researchers and medical professionals to unpack the myriad of reasons for lower breastfeeding rates in fat women and to take effective action. Headlines futilely recommending weight loss, and further stigmatising fat women, do not help. Drumming up panic about how infant formula use promotes obesity without actually supporting women to establish and continue breastfeeding is not helpful. Shame is not helpful. Lactivists and birth activists and sympathetic health professionals must be size accepting, or they do a disservice to a significant percentage of mothers and their families.

Ending fat phobia and misguided health information founded in obesity panic is not just about making it easier for fat adults to eat whatever they like without shame. It’s about making it possible for infants to eat what they need, without anyone feeling ashamed, too.