Table 3.

Subthemes and Categories That Emerged in Theme 3 (Challenges for Health Professionals), with Example Quotations

Theme, subtheme	Category	Example quotations (participant)
Challenges for health professionals
Obese patients require “more”	Time consuming	“Breastfeeding takes a back seat to comorbidities in pregnancy so the breastfeeding becomes a little bit less important …” (16MD)
	Physical effort	“It's more work for the mom, more work for the nurse…physically more work.” (15CNM)
		“… your back is breaking because you're leaning over them…it's more difficult for the healthcare worker when [women are] obese, too, because it's strenuous on our bodies, the positioning, the work we have to do.” (02RN)
	More challenging	“And you just have to keep trying different things…because I remember one not too long ago, it was ‘oh my gosh, how do I get this to work?’” (12LC)
		“… It's a little bit easier to have a patient who is not attempting to breastfeed and they've got enormous pendulous breasts and you've got positional, you know, issues with the patient.” (05RN)
Awareness of stigma and need for sensitive care	Stigma awareness	“… obese people often start to pull back from the medical world because there's so much discussion about the weight loss.” (03LC)
	Normalizing/minimizing obesity	“Well, if the breasts are a little bit larger and they've got challenges with their nipples, I'll say like ‘Oh my gosh, a lot of women have that problem,’ you know…but I guess normalizing. I use that technique a lot.” (05RN)