BEARR RCT

BEARR is a randomized controlled trial that investigates the positive influence of breastfeeding on significantly overweight mothers and their babies. It is known that women who are overweight not only have an increased risk of metabolic diseases (e.g. type 2 diabetes mellitus), but also have more difficulties with breastfeeding.

We offer these women the free opportunity to be accompanied and supported by a trained breastfeeding consultant for the first 5 months. The breastfeeding counselor provides information, gives practical tips and is the contact person for all your questions about breastfeeding.

If you are assigned to the consultation group (intervention group), you will benefit from intensive personal and telephone breastfeeding advice from one of our certified breastfeeding consultants for up to 5 months after the birth.

If you are assigned to the control group, you will of course still receive standard care in the clinic and from your aftercare midwife at home.
Both groups will receive a free health check 6 - 7 months after the birth, during which we will determine your blood sugar levels. In addition, the child's weight development is recorded using the child examination booklet.

The BEARR program investigates whether intensified breastfeeding support (in addition to the standard care provided by the follow-up midwife) can 1. contribute to an increased breastfeeding rate or extended breastfeeding duration, 2. reduce the maternal risk of developing a

Primary endpoint:

1. frequency of breastfeeding 2 weeks after birth ("breastfeeding initiation").
2. breastfeeding rate (exclusive or full breastfeeding) 6 months after birth.

Secondary endpoint:

1. maternal fasting glucose, glucose tolerance and HbA1c 6 - 7 months postpartum.
2. weight and height development of the child from birth to 6 - 7 months of age.

Obesity as a global problem is associated with insulin resistance and type 2 diabetes mellitus (T2DM), among other things. In Germany, 38.5% of women of childbearing age are overweight, of which 15.3% are obese.

Obesity and metabolic disorders during pregnancy can have long-term health consequences for mother and child. In the PEACHES mother-child cohort, we have shown that in obese mothers with a high glycated haemoglobin level (HbA1c ≥ 5.7%) at delivery, despite negative testing for gestational diabetes (GDM), the mother's postpartum risk of prediabetes or T2DM is increased. In addition, this is associated with a higher body mass index (BMI) z-score of the children at the age of 4 years.

Breastfeeding can, among other things, reduce the risk of T2DM in the mother and obesity in the child. However, breastfeeding rates are generally low and the duration of breastfeeding is short, especially in obese women.

In addition to hormonal and mechanical difficulties, obese mothers also have other factors that indicate a particular need for support for this vulnerable group. Although individual intervention studies suggest that breastfeeding support appears to have a positive effect on breastfeeding rates in women with different BMIs, the results are not clear, partly due to flaws in the study design and high loss to follow-up rates. The diagnosis of GDM also appears to be associated with lower breastfeeding rates.

Sternstunden e.V.
Oskar-von-Miller-Ring 3
80333 München
Deutschland