Maternal overweight, infant feeding and early growth velocity are risk factors for obesity later in life. The first one thousand days are a window of opportunity to program health and disease. Exclusive breastfeeding may protect against obesity; however, it is not consistently practiced. Obesity rates have been increasing worldwide. Overweight or obese women have lower rates of breastfeeding and face mechanical, psychological and biological difficulties. Breastfeeding counselling is a successful strategy to support breastfeeding in normal weight women; but there is a lack of evidence on its effectiveness in overweight women. Our purpose is to evaluate a new approach to exclusive breastfeeding counselling based on Carl Rogers’ Centred-Client Theory in overweight women, and to examine effects on breastfeeding prevalence, infant growth velocity and maternal postpartum weight loss. A two-arm simple randomized controlled trial will be conducted in overweight and obese women recruited in a Baby Friendly Hospital in Bogotá, Colombia. The intervention is exclusive breastfeeding counselling based on Rogers’ theory but adapted for overweight women; it will be performed during the last month of pregnancy, 24 h after delivery and during early infancy (1 and 3 months postpartum). The primary outcomes will be exclusive breastfeeding prevalence, infant growth velocity and maternal weight loss from birth up to 4 months after delivery; and the secondary outcomes will be prolactin and macronutrient levels in breast milk and serum prolactin levels. Intention to treat analysis will be performed to estimate the effect of the new counselling approach compared to standard management on the prevalence of exclusive breastfeeding, infant growth velocity and maternal weight loss. We hypothesize that the intervention will result in an increase in the initiation and maintenance of exclusive breastfeeding, allowing adequate infant growth velocity and maternal weight loss after delivery. It is hoped that the results of this trial will provide evidence to support public health policy on supporting breastfeeding in this vulnerable group of women. (UTN) U1111–1228-9913 February 20th 2019; ISRCTN15922904 February 27th 2019, retrospectively registered.

中文翻译：

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针对超重或肥胖妇女的母乳喂养患病率，婴儿生长速度和产后体重减轻的独家母乳喂养咨询新方法的有效性：一项随机对照试验的方案。

产妇超重，婴儿喂养和早期生长速度是生命后期肥胖的危险因素。前一千天是编程健康和疾病的机会之窗。纯母乳喂养可以预防肥胖；但是，并非始终如此。肥胖率在世界范围内一直在增加。超重或肥胖的妇女母乳喂养率较低，并且面临机械，心理和生物学方面的困难。母乳喂养咨询是支持正常体重妇女母乳喂养的成功策略。但缺乏证据表明其对超重女性有效。我们的目的是根据卡尔·罗杰斯（Karl Rogers）的“中心客户理论”评估超重女性的独家母乳喂养咨询新方法，并研究其对母乳喂养患病率的影响，婴儿的生长速度和产妇体重减轻。将对哥伦比亚波哥大一家婴儿友好医院招募的超重和肥胖妇女进行两臂简单随机对照试验。干预是基于罗杰斯理论的独家母乳喂养咨询，但适用于超重妇女；它将在怀孕的最后一个月，分娩后24小时以及婴儿早期（产后1和3个月）进行。主要结局将是母乳喂养的普遍发生率，婴儿的生长速度和分娩后直至四个月的产妇体重减轻。次要结果是母乳中的催乳素和大量营养素水平以及血清催乳素水平。将进行治疗意向分析，以评估与标准管理相比，新咨询方法对纯母乳喂养，婴儿生长速度和孕产妇体重减轻的影响。我们假设干预将导致纯母乳喂养的开始和维持增加，从而使婴儿在分娩后具有足够的生长速度和产妇体重减轻。希望这项试验的结果将为支持这一脆弱妇女群体支持母乳喂养的公共卫生政策提供证据。（UTN）U1111–1228-9913 2019年2月20日；ISRCTN15922904 2019年2月27日，进行了追溯注册。我们假设干预将导致纯母乳喂养的开始和维持增加，从而使婴儿在分娩后具有足够的生长速度和产妇体重减轻。希望这项试验的结果将为支持这一脆弱妇女群体支持母乳喂养的公共卫生政策提供证据。（UTN）U1111–1228-9913 2019年2月20日；ISRCTN15922904 2019年2月27日，进行了追溯注册。我们假设干预将导致纯母乳喂养的开始和维持增加，从而使婴儿在分娩后具有足够的生长速度和产妇体重减轻。希望这项试验的结果将为支持这一脆弱妇女群体支持母乳喂养的公共卫生政策提供证据。（UTN）U1111–1228-9913 2019年2月20日；ISRCTN15922904 2019年2月27日，进行了追溯注册。