Submitted to: New England Journal of Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: February 17, 2000
Publication Date: N/A
Technical Abstract: A recent article by Lovelady et al. reported an intervention trial in which overweight, lactating women were randomly assigned to either a dieting- exercise (n=21) or control group (n=19) at 4 wk postpartum for 10 wk. Clinical concerns are whether energy restriction compromises milk production and thereby infant growth, and whether dieting-exercise programs sare recommendable for overweight, lactating women so soon after delivery. Assurance that the intervention did not compromise the growth of any of the infants is needed. The 95% confidence interval indicates the true mean difference in infant weight gain lies somewhere between -280 to 409 g, therefore, the results are inconclusive. The large SD in weight gain suggests that the growth of some infants in the intervention as well as the control group might have been inadequate. It is important to consider whether a dieting-exercise program is appropriate for overweight, lactating gwomen so soon after delivery. For the health and well-being of the mother- infant dyad, the nutritional aim should be to produce balance in maternal weight and body composition over the entire pregnancy-lactation cycle, not in the early postpartum period.