Body Image of Mothers

Diana West, BA, IBCLC and Lisa Manning

The transformations of pregnancy and motherhood can magnify our self-image. Many women discover a new physical empowerment, but others are left feeling a quiet misery of unattractiveness. A quick glance at online forums for new mothers confirms there are many ways that postpartum changes affect women’s feelings about their bodies. Becoming a mother can improve the way many women feel about their physical selves. Others are disturbed with the negative changes that birth and aging can bring. Some women feel both ways or go back and forth. There’s no doubt, though, that most of us would change something about ourselves in an instant. It’s easy to think that other women are managing postpartum changes better than we are. The reality is that no matter how we feel about our bodies yesterday, now, or tomorrow, there are millions of women around us feeling exactly the same way. Mothers post on social media about their frustrations with their postpartum bodies. Their comments range from humorous resignation about their “tiger stripes” and “wobbly” bellies to dark depression and self-loathing.

In this article, we want to dig deeply into this common phenomenon of discomfort with our own bodies.

Why do so many of us feel so bad about ourselves?

Why do we carry this lurking misery in our hearts? How can we lift each other out of the quicksand of body shame? In addition to exploring the underlying reasons and psychology, we will also share the personal body image journeys of several brave women (including ourselves!) as a way to open the door to an honest dialogue. Knowing we’re not the only ones grimacing in the mirror may be reassuring. Understanding how truly normal our bodies are may help shift our perceptions in a more positive direction.

Why do we think postpartum bodies are less attractive?

In Western culture, beauty is (unfairly) correlated with success and ability, so that the more attractive a woman is, the more successful and capable people think she is.¹ Of course, female beauty is entirely relative. Facial beauty usually depends on symmetrical features,² but the perception of physical beauty depends on where and when a woman lives. In some times and places, such as ancient and traditional societies, where weight equalled prosperity and survival during hard times, a heavy woman was revered. In modern times and First World societies where food is plentiful and thinness is equated with self-discipline, self-care, and productivity,³ heavy women are more likely to be reviled. Unfortunately, the definition of “heavy” has changed. Ultra-thinness has become the ideal in most places now, whether or not a woman is fit or healthy.

Youth is another important variable in the perception of attractiveness. As we age and our bodies change after pregnancies, we often begin to feel invisible in public. This is especially noticeable for those of us who were used to smiles and special courtesies from strangers when we were younger.

Today’s women tend to be unhappier with their bodies than men are,⁴ probably because our culture places more emphasis on female attractiveness than male. This trend is increasing dramatically,⁵ most likely because of the increase in media messaging.⁶ Yet, many of those images aren’t even real—either they’ve been “Photoshopped” or the women have had “work done” (cosmetic surgery).

A 2008 meta-analysis (study of other studies) by Grabe, Ward, and Hyde showed that female models and actresses employed in traditional media—movies, television, and magazines—have become thinner and thinner over time, often beyond the criteria for anorexia.⁷ Extremely thin women far outnumber heavier ones in the media, and disproportionally represent the true weight of real women in their audiences. Seeing ultra-thin women in every type of media makes us think it’s normal and necessary for attractiveness, creating a standard that is unattainable for most of us, especially after giving birth.⁸ Then we’re bombarded with celebrity advice about how to get back in shape after pregnancy, implying that our looks are more important than our mothering. Finally, images of gorgeous women on social media flood our phones, tablets, and computers.

This unrealistic ideal is thrust in our line of sight countless times each day, and we consciously or subconsciously compare our bodies, often finding them lacking. These images don’t affect all of us the same way, but few of us are immune.⁹ Having experienced the most profound physical transformation of our lives, living in a body that is unfamiliar and exaggerated, many of us are left feeling miserable, undesirable, and ashamed of our bodies after childbirth. When we bury our pain and isolate ourselves because we feel unattractive, we can become mired in toxic negativity that only makes us feel worse.

In Body Wars, Margo Maine looks at the effect of culture on women’s physical self-perceptions.

“Our preoccupation with a narrow definition of female beauty renders women subordinate, insecure, powerless, and fighting Body Wars instead of living full lives. Let us return to the definition of beauty – those things that ‘stir the senses or the mind at the highest level’ – and stop reducing the value of females to physical appearance. It is time to quit trivializing and discounting women’s accomplishments and worth and to declare an end to Body Wars. It is time to allow women to have real power.”

Beauty in the eye of the beholder

How we see ourselves in the eyes of our immediate family and friends plays an important role in our self-image. A 2005 study by Jordan, Capdevila, and Johnson confirmed what many of us already know—support and approval from those around us can determine how comfortable we are with our body’s postpartum appearance.¹⁰ When we see approval and acceptance in our loved ones’ eyes, it’s easier to like and accept ourselves.

Janet shared her story, “I was (am) a very small woman, I’m 5 ft/1.5 m tall and at the time I first became pregnant weighed 115lb/52 kg. About the time I began to show with my first baby, my then-husband decided I was ‘fat’ and didn’t want to have anything to do with me sexually. Needless to say, this did nothing for my self-esteem. His rejection of me, especially when I really wanted sex caused me to have self-esteem and body image issues that lasted until my divorce. It was then I discovered that I am actually desirable despite the changes of pregnancy and natural aging. Getting to this point took time, and honestly it took the assurances of others, men and women, to help me understand that physical beauty is a sum of the whole package.”

Of course, feeling comfortable in our own skin isn’t the same as how we truly perceive our bodies. Most of us—especially those who feel the least attractive—don’t see our bodies realistically.¹¹ We aren’t as fat or ugly as we think we are. It can be hard to believe, but most people think we look just fine. We might start to believe it, but then we see an image of a beautiful woman and once again we think how far short we fall.

Becoming a mother, whether by birth or adoption, has the potential to magnify our feelings about our body because it is through our body that we nurture our children, whether by growing them, holding them, or feeding them. A study in 2008 by Clark et al found that women are often happier with their pregnant body because it is a time in their lives when society clearly approves of not being thin and they know the weight gain is for the wonderful purpose of growing a baby. But when the baby is born, the “excuse” is gone and the old pressure to be thin returns.¹² The feeling of body dissatisfaction seems to peak between 6–18 months after birth. An interesting finding was that one reason women like their postpartum body less is that they think that their body is less useful after birth.¹³

Half the mothers in Clark’s study expressed frustration about the way their body looked after birth and the lack of control they had over this. One mother shared this familiar feeling, “My stretch marks are so depressing. It seems like half the time I feel good about my body and the other half not. During pregnancy I felt great about myself, knowing that my body was doing exactly what it was made to do.”

Other women in Clark’s study admitted they didn’t like how they look, but said they were too busy to care.¹⁴ Alina shared her experience with us, “I was brought up by a mother obsessed with being thin, who transmitted her obsession to me. Before giving birth I made an effort to accentuate my waistline, but now that I don’t have much of one, rather than feeling ashamed like I did years ago, I’m pretty neutral on the matter. I’ve got more on my plate now and my waistline has to wait in line.”

Add breastfeeding into the mix

How is the feeling of physical usefulness affected by breastfeeding? Certainly, nurturing a baby with your body can make a woman feel ultimately instrumental to her baby’s wellbeing. But when breastfeeding doesn’t go well, it can compound a woman’s feelings of failure and frustration that her body didn’t work the way it was supposed to.¹⁵ Many women feel guilt and even shame. Amy confided, “My body is broken and has failed me. It took many years to get pregnant. And I never made more than an ounce of milk at a time to feed my sweet boy, despite trying nearly everything.”

How breastfeeding will affect your body is a concern for many women. A study in Japan found that intensive cultural pressure to return to pre-pregnancy body shape reduced the length of time women breastfed, often because of concerns about how it would affect the shape of their breasts.¹⁶ A large English study of 12,000 women that examined the effect of body shape and weight concerns on the intention to breastfeed found lower breastfeeding initiation rates in women who were more concerned about their body shape and weight.¹⁷ This finding may also reflect a discomfort with intimacy experienced when women feel their bodies are unacceptable, even to their own babies.

When breastfeeding goes well, a mother is often surprised to discover newfound awe and respect for her body’s ability to nurture her vulnerable baby. Susan told us, “When I look in the mirror, I am so incredibly proud. Breastfeeding never crossed my mind growing up, or when I was buying fancy lingerie, or lamenting B cups. And now, I look at my breasts and am in awe and at peace with my body in a way I never thought possible. And the more time that passes, the more amazed I am at how perfect two breasts could be and how miraculous pregnancy and childbirth are.”

Ashley agreed, “After the birth of my son I told myself, ‘If I can birth this baby then I can nourish him as well.’ Although I’m currently 14 lb/6 kg over my pre-pregnancy weight, I promised myself that I would nourish my body with healthy, nutrient-dense foods to promote optimal lactation. I’m nowhere near my ‘goal’ weight, but knowing that my body is doing amazing things and producing milk for my baby is worth it! I love watching him grow and I can lose the extra weight once he’s weaned.”

Christine shared, “I am proud of my body after birthing and breastfeeding two large babies. I respect it so much more and no longer fret about the superficial stuff.”

Robyn told us how breastfeeding changed her opinion about her breasts, “I was a late bloomer and was made fun of horribly in school for having small breasts. Because of that I hated my breasts and thought their size made me ugly. When I became pregnant with my first baby, I wasn’t sure I’d be able to breastfeed because of my small breasts. Well, three children and 13 years of non-stop breastfeeding later, I’m proud to say my little breasts did their job beautifully. I am now very proud of my small breasts!” 

Leigh Ann said, “I felt a new sense of empowerment in myself first by being pregnant and watching my body grow a baby. I gained an even greater sense of self-respect and power by growing my baby at my breast. I have always struggled with body image, but I learned to check it so it would not rub off on my children. I also learned to love my body because my children and husband love my body. My body is the house where my spirit lives.”

Long-time La Leche League Leader Diane Wiessinger told us about watching a slide show of normal postpartum breasts. As she saw slide after slide of torsos go by, it occurred to her that most of the owners of those breasts probably look in the mirror and think how ugly their breasts are, sure that they aren’t good enough. Yet all those healthy, functional, normalbreasts were making the milk on which their babies thrived. She thought how sad it was that most people think the mature woman’s breasts aren’t as beautiful as virginal, immature breasts.

She also added, “I’ve been in a nude sauna in Finland, and I’ve been on a topless beach in Mexico. I had no problem with bare breasts in either place. I just didn’t want people to see my stomach.”

Nikki Lee shared this insight, “I was in a sauna once, with women of all ages. Those of us who had breastfed were proudest, most accepting of their breasts, and least critical of their size and shape. Seems as though our body image was bolstered by using our breasts for what they were made to do.”

One New Zealand mother confided, “I feel as though my body properly matured with breastfeeding. I got a bigger cup size with my first two pregnancies (including the miscarriage), and my body has bounced back to my pre-birth size now. New faith in my body and what it can do. Never felt sexier. Nipple sensitivity has changed too. I used to find partner stimulation annoying, but am not so worried now. Only down side is sticky-outy nipples—they are elastic! That surprised and amazed me!”

An interesting phenomenon is the “brelfie,” a breastfeeding selfie. According to a recent survey, one in five mothers has shared one online. In fact, Netmums.com lists brelfies as the number one parenting trend for 2015. That makes us wonder, do we post brelfies in spite of our body image issues because showing our pride in breastfeeding is more important or does posting them help us feel more positive about our body?

Chrissie Russell shared her thoughts about brelfies in the Irish Independent, “I’ll wager it’s the same reason most women take any selfie—it’s a happy memory you want to record. I’m not under any illusions that I look great breastfeeding. I don’t. My six-month-old son, Tom, is a big boy and the comfiest way for us to feed is with me slumped and him sprawled like a sky-diver on my chest. But sometimes it’s at my breast when he is most calm, and when I see his contented little face it’s a lovely moment. And even though I’m dressed in a stained dressing gown with unwashed hair and bags under my eyes, he looks up at me like I’m the most ravishing thing he’s seen. I want to bottle that feeling, so I take a picture.”

Then we hit menopause

Just when we might be starting to make peace with our body, it takes a sharp turn into menopause, which changes everything. The weight can pile on, the skin become drier (everywhere), the joints may creak, the wrinkles appear, and the hair (if it hasn’t already) starts to grey. If we weren’t invisible before, the changes of menopause can be our first experience of fading into the background. This can magnify our feelings of body-image misery.

Denise shared her experience, “A lot of the hormone surges very much reminded me of early postpartum days. I also had to drastically change my diet. I had to really work to overcome (well, still working on it) self-hate when I look in the mirror because my waist is still thick but my butt disappeared completely.”

Diana’s body story

Even though I know many women reading these words will do so kindly, this is a very difficult experience to share publicly. I’m running a real risk of “oversharing.” But I’ve decided it’s important to be brutally forthcoming about my feelings about my body because I know I’m not the only one who feels this way.

So here I am, at nearly 50 years old. I feel constantly embarrassed by my face, my weight, and my sagging curves, and wish with all my heart that I looked better. But it wasn’t always this way.

When I was a teenager, I was painfully thin and easily mistaken for a flagpole. My ever so helpful classmates pointed out that my huge nose and receding chin gave me a more-than-passing resemblance to a turtle. I spent hours studying Seventeen magazine for ways to improve my appearance, learning complicated hairstyles and makeup techniques. To improve my posture and movement, I took several ballet classes each week, biking a ten-mile round trip to each class.

When I turned 16, my breasts suddenly started to grow very large. I’ll never forget the day I went swimsuit shopping and discovered to my delight how curvaceously I filled out every suit I tried on, fully eclipsing any nose or chin issues. I felt sexy and powerful. But those large breasts made ballet difficult because they threw off my center of balance and got in the way, so I stopped going. The reduced activity, or maybe just the cafeteria food at college, made me gain a few pounds, but I was still thin, had plenty of dates, and felt mostly okay about how I looked. Sometimes I even felt attractive.

Over the next few years, though, my breasts began to annoy me more and more—they made it hard to exercise and find clothes that fit, and they made me uncomfortably conspicuous to men. In my early 20s, I decided to have breast reduction surgery to make my breasts more proportional to the rest of my body. Insurance covered the cost and I was delighted by the result. I finally felt normal.  And, when my makeup and hair were done to minimize the nose and chin, I looked great.

Around this time, I remember a colleague who was nice but quite heavy. I’m mortified now to remember an awful comment I made about her weight. Fortunately it was said out of her hearing, but boy does it haunt me—it was so awful that I won’t even tell you what it was.

A few years later, I began dating the guy who would become my husband. He asked me to stop smoking. Even though I’d only smoked in bars and coffee breaks, I noticed almost immediately that I began to gain weight, even though I wasn’t eating differently. Between the time I selected my wedding dress and the week of our wedding, I’d gained enough weight that a seamstress had to let out my dress. I still looked fine, though and now I love seeing how thin my waist was in those wedding pictures. But the weight creep had begun.

I became pregnant with our first baby two years later. For the first time since college, I felt free to eat as much as I wanted because “I was eating for two.” I lovingly held my pooching tummy at two months pregnant (I’m sure no one rolled their eyes). What freedom and bliss!

When Alex was born, I began a frustrating breastfeeding journey. When I realized I didn’t have enough milk, I felt a mixture of guilt and grief. Things changed when my second baby, Ben, was born. Not only did he nurse happily, but I also had tons of milk despite every expectation that I wouldn’t. I remember introducing myself at a La Leche League meeting with, “I’m Diana West and I have glorious breasts!” (The group knew my back-story and laughed.) They were glorious: they had overcome what I had done to them and were making so much milk that my baby was fat! I felt incredibly fortunate.

For a while, my gratitude for my breasts’ capabilities spilled over into how I felt about the rest of my body. I liked the way my children molded around my soft curves. I liked the way they looked at my face without judgment, just as I did theirs, because they loved me (the real me inside) unconditionally. So I happily wore my nursing dresses and stretchy “mommy” clothes during Ben’s toddlerhood. I wasn’t really heavy and was mostly happy with my body, for the first time in years. I was proudly aware that my body had successfully given birth and (mostly) fed my babies. I felt like a mother-goddess, loving, nurturing, and beautiful.

Until about 18 months after the birth of my third baby, Quinn, when a woman standing next to me in line at a store pleasantly asked when my baby was due. I looked down at my pooching belly and realized I’d crossed the line from normal to fat. Horrified, I decided to go on a very strict low-carb diet (the first of my life) and lost 45 lb/20 kg in just two months. I became thinner than my wedding weight, but my tummy still pooched. I discovered a very large separation in my abdominal muscles from the three pregnancies, so I looked pregnant even though I wasn’t. Boy was that frustrating. A tummy tuck would have been nice but was unaffordable.

As soon as I added carbs back into my diet, I began regaining the weight I had lost and then some. Two years after starting the diet, I weighed 20 pounds more than before I started it. So I went back on the diet. Lost some weight. Gained it back in a typical yo-yo pattern, eventually “dieting” to 80 pounds above my wedding weight. My breasts grew until they were larger than before my reduction surgery. But now I no longer have babies to love me unconditionally.

My feelings about my body have become increasingly negative. I hate looking in the mirror now. It’s shocking to see my reflection because I actually feel thin and svelte inside.    

I compare myself to every woman I see, always falling short. When I met Lisa (my co-author for this article) at a conference, I felt keenly aware of my weight compared to her glamourous good looks and normal-shaped body. I never dreamed she had any weight concerns. But it’s the reactions of people around me that cement the way I feel about my body. One friend recently patted my belly and said, “I just worry about you.” Another woman told me how worried she was about my health because of my weight.   

This self-consciousness plagues me even when I’m doing what I enjoy most, speaking at conferences. I feel very confident about my information when I’m talking, but there is always an awareness in the back of my mind that someone (or several someones) in the audience is looking at me with disgust. I’ve tried every type of control garment I can find, but they were all so incredibly painful after a few hours that I decided to put my effort into finding flattering clothes. I paid for professional publicity photos, but one woman said, “Gosh, your photographer did a good job!” Now I’m always aware that people expect me to look as good as my photo and will notice how much worse I look in person. I’m afraid to diet again and I’m afraid not to.

Now when I see a heavy woman, I feel instant empathy and compassion, and usually think how nice she looks. I think women look better with soft curves. But I know the rest of the world doesn’t think that way, and it’s against their standard that I judge myself. No matter how hard I try, I can’t seem to keep myself from cringing at that reflection in the mirror.

Lisa’s body story

I have yo-yo dieted since I was 18. I don’t remember my breasts being anything less than a DD cup size. Today I am a G cup. I have never felt they were sexy; mostly a nuisance, and sometimes a point of ridicule. I will never forget my embarrassment at the vulnerable age of 15, when standing with my arms crossed, a guy laughed and remarked, “Are you holding them up?” I was mortified. When I carry extra pounds (which is most of the time) I hide them under baggy garments and, on the few occasions when I have slimmed down, I only wear so-called minimizing bras and still cross my arms over my chest in public.

While I actually loved my pregnant body, I struggled to find maternity bras big enough and then, after Maia was born, on top of the ongoing issues with the size of my breasts, I was having considerable difficulties with breastfeeding my child. (This came as no surprise to one aunt who had repeatedly told me, “You won’t be able to breastfeed. We are too big.” Such nonsense!) But funnily enough my focus was not on the size of my breasts at that point, it was on what they were doing. As I overcame difficulty latching, bacterial infections, thrush, and mastitis, I marveled at what my body was doing.

Three months later, the weight started falling off. I was slimmer than I had been for years; my breasts were a little smaller but doing their job beautifully and I felt fabulous. “That’s all you, that is,” my husband would remark as he fondly watched Maia at my breast hour after hour. I think it helped me adjust to my changing body. But pride at what I was achieving didn’t last beyond the first year and initial weight loss. As it had most of my life, my weight yo-yo’d. And then wham, long before Maia weaned, menopause struck. And that too has had a significant impact on my own body image.

I was only 42 when the hot flushes started and because I was still breastfeeding, I didn’t realize what was happening. My hormones were all over the place, and still are eight years later.

I  know that when I am exercising and “making an effort,” I feel better about myself. The lardy arms, wobbly bottom, and orange peel thighs don’t seem to matter quite so much. It’s all about perception isn’t it? How I see myself isn’t how my husband sees me. “I know women who would kill for your head of hair, Lisa,” he says. I think it’s a hideous mess of unruly curls. How I see Diana certainly isn’t how she sees herself. Watching her speak at conference, she was a joy to behold.

A body image therapist weighs in

Carole Goldstein, MA, MFT, LAC, MS, RD, an eating disorder and body dysmorphia therapist in New Jersey, USA, shared the following story and excellent insights with us.

I grew up hearing my maternal relatives’ lament, “too bad the girls are the heavy ones” so that I internalized being heavy as fact. In retrospect, and with photographs of my older sister and me in our dance costumes to prove it, neither of us was overweight.

Fast forward ten years, and it’s no wonder I developed eating disordered behaviors and body dysmorphia. Fast forward another decade, it took the difficulty of losing weight from my first pregnancy and gaining too much in my second to damage my fragile self-concept enough to make me want to learn how finally to fix my body and learn how to eat well. What better way than to become a registered dietitian/nutrition therapist? 

I began to specialize in the treatment of eating disorders, anorexia, bulimia, binge eating, and those not otherwise specified. My clients’ weight ranged from about 69–400+ pounds. I came to the realization that the more extreme the weight at either end of the spectrum, the more misery the person was in. “Prison,” “trapped,” “isolated,” “lonely,” “fear,” “despair” are a few of the words my clients have used to describe the experience of inhabiting their bodies. 

I can tell stories of women so terrified of the changes pregnancy would have on their body that abortion seemed the only solution. I can tell other stories of drop-dead gorgeous young women, completely crippled by feeling fat, unable to see their thinness, their beauty, or their worth. So many stories.

Before we judge any of them too harshly, perhaps we should look more closely at the culture that idolizes one body type and shape and purposefully delivers messages via every media outlet to shame the rest of us, reinforcing the myth that if we only had more self-control, bought this product, tried this diet, weren’t so lazy, and on and on, we could look like this ideal. We have bought into these myths so completely that some doctors are recommending gastric bypass surgery to teenagers. Yes, really, I hear such stories.

And perhaps therein lies the secret. In the telling of these stories, there is hope. Diana, Lisa, and the others who have shared their stories are questioning the ideals about body shape and size that have been imposed on us. Questioning the shame of living in a less than perfect body and the cost of the pursuit of the unatttainable. I believe it was Cindy Crawford who, after viewing one of the ads she posed for, stated, “I wish I looked like Cindy Crawford!”

Building bridges to acceptance

True beauty comes from within, but we think that only applies to other people. It can be hard to accept ourselves as these two women have done:

“What I would say to any woman is celebrate the body you have at this moment but don’t look back either. Each line, each mark, each scar tells a story. My body is a rich expression of my own journey as a mother and I am proud of it. It tells the story of creation, of nourishment, of pain, of joy. It is part of who I am.” Angela.

“I finally have come to appreciate the ability my body has to change, because without it changing, my babies wouldn’t be here. It’s new, it’s different, but I’m proud of it.” Melinda.

So let’s keep telling our stories. The more we share them, the more we’ll begin to understand that our bodies really are normal and our cultural expectations really aren’t. Sharing stories allows us to share vulnerabilities that build bridges of mutual acceptance between us, making how the wider world wants us to look less important. These bridges may even take us to a place where we can value our inner selves most, freeing us to nourish our body and spirit in a way that builds true health, regardless of shape or size. After all, people won’t think about the shape of our bodies after we are gone, only the shape of our hearts.

For most women, dissatisfaction with our body size or shape is ever present, but mild enough that it doesn’t affect everyday functioning. When self-image concerns get in the way of daily activities and normal productivity, a therapist experienced in Body Dysmorphic Disorder can offer effective treatments and therapies. 

References

¹Feingold, A. Good-looking people are not what we think. Psychological bulletin 1992; 111(2): 304.

²Rhodes, G., Proffitt, F., Grady, J. M., & Sumich, A. Facial symmetry and the perception of beauty. Psychonomic Bulletin & Review 1998; 5(4): 659-669.

³Thompson, C. J., & Hirschman, E. C. Understanding the socialized body: a poststructuralist analysis of consumers’ self-conceptions, body images, and self-care practices. Journal of Consumer Research 1995; 139-153.

⁴Striegel-Moore, R. H., & Franko, D. L. Body image issues among girls and women. Body image: A handbook of theory, research, and clinical practice 2002; 183-191.

⁵Feingold, A., & Mazzella, R. Gender differences in body image are increasing. Psychological Science 1998; 9(3): 190-195.

⁶Roth, H., Homer, C., & Fenwick, J. Bouncing back: How Australia’s leading women’s magazines portray the postpartum body. Women and Birth 2012; 25(3):128-134.

⁷Grabe, S., Ward, L. M., & Hyde, J. S. The role of the media in body image concerns among women: a meta-analysis of experimental and correlational studies. Psychological bulletin2008; 134(3): 460.

⁸Ibid.

⁹Yamamiya, Y., Cash, T. F., Melnyk, S. E., Posavac, H. D., & Posavac, S. S. Women’s exposure to thin-and-beautiful media images: Body image effects of media-ideal internalization and impact-reduction interventions. Body image 2005; 2(1): 74-80.

¹⁰Jordan, K., Capdevila, R., & Johnson, S. Baby or beauty: a Q study into post pregnancy body image. Journal of reproductive and infant psychology 2005; 23(1):19-31.

¹¹Cash, T. F., & Pruzinsky, T. Body image: A handbook of theory, research, and clinical practice2004; The Guilford Press.

¹²Clark, A., Skouteris, H., Wertheim, E. H., Paxton, S. J., & Milgrom, J. My baby body: A qualitative insight into women’s body‐related experiences and mood during pregnancy and the postpartum. Journal of reproductive and infant psychology 2009; 27(4): 330-345.

¹³Ibid

¹⁴Ibid

¹⁵Orbach, S. Breastfeeding failure leads to increased body dissatisfaction. Bodies 2009; Macmillan.

¹⁶Inoue, M., & Binns, C. Weight Gain: Women’s attitudes, health implications and psychological challenges 2013; New York: Nova Science Publishers, Chapter 3: 63.

¹⁷Barnes, J., Stein, A., Smith, T., & Pollock, J. I. Extreme attitudes to body shape, social and psychological factors and a reluctance to breast feed. Journal of the Royal Society of Medicine1997; 90(10): 551-559.

Diana West, BA, IBCLC, is an LLL Leader and one of the co-authors of the LLLI books The Womanly Art of Breastfeeding and Sweet Sleep. She is co-author with Lisa Marasco, MA, IBCLC, of The Breastfeeding Mother’s Guide to Making More Milk, and with Dr. Elliot Hirsch of Breastfeeding After Breast and Nipple Procedures. She is also author of the Clinician’s Breastfeeding Triage Tool and Defining Your Own Success: Breastfeeding After Breast Reduction Surgery.

Lisa Manning is a retired La Leche League Leader. Born in London, she trained at the BBC and is an award-winning journalist, former TV reporter, presenter, and producer. She has lived in New Zealand for most of the last 20 years with husband John and their daughter, Maia.