Document Detail

Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding.
MedLine Citation:
PMID:  20573792     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Delayed onset of lactogenesis (OL) is most common in primiparas and increases the risk of excess neonatal weight loss, formula supplementation, and early weaning. OBJECTIVE: We examined variables associated with delayed OL among first-time mothers who delivered at term and initiated breastfeeding (n = 431). DESIGN: We conducted in-person interviews during pregnancy and at days 0, 3, and 7 postpartum and extracted obstetric and newborn information from medical records. We defined OL as delayed if it occurred after 72 h and used chi-square analysis to examine its association with potential risk factors across 6 dimensions: 1) prenatal characteristics, 2) maternal anthropometric characteristics, 3) labor and delivery experience, 4) newborn characteristics, 5) maternal postpartum factors, and 6) infant feeding variables. We examined independent associations by using multivariable logistic regression analysis. RESULTS: Median OL was 68.9 h postpartum; 44% of mothers experienced delayed OL. We observed significant bivariate associations between delayed OL and variables in all 6 dimensions (P < 0.05). In a multivariate model adjusted for prenatal feeding intentions, independent risk factors for delayed OL were maternal age > or =30 y, body mass index in the overweight or obese range, birth weight >3600 g, absence of nipple discomfort between 0-3 d postpartum, and infant failing to "breastfeed well" > or =2 times in the first 24 h. Postpartum edema was significant in an alternate model excluding body mass index (P < 0.05). CONCLUSIONS: The risk factors for delayed OL are multidimensional. Public health and obstetric and maternity care interventions are needed to address what has become an alarmingly common problem among primiparas.
Laurie A Nommsen-Rivers; Caroline J Chantry; Janet M Peerson; Roberta J Cohen; Kathryn G Dewey
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2010-06-23
Journal Detail:
Title:  The American journal of clinical nutrition     Volume:  92     ISSN:  1938-3207     ISO Abbreviation:  Am. J. Clin. Nutr.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376027     Medline TA:  Am J Clin Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  574-84     Citation Subset:  AIM; IM    
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.
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MeSH Terms
Birth Weight
Body Mass Index
Breast Feeding*
Chi-Square Distribution
Edema / physiopathology
Infant, Newborn
Interviews as Topic
Lactation / physiology*
Logistic Models
Maternal Age
Models, Biological
Obesity / physiopathology*
Puerperal Disorders / physiopathology
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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