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Delayed lactogenesis and excess neonatal weight loss are common across ethnic and socioeconomic categories of primiparous women in northern California
Author(s) -
Dewey Kathryn G,
NommsenRivers Laurie,
Cohen Roberta J,
Chantry Caroline J.,
Peerson Janet M
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.344.7
Subject(s) - breastfeeding , medicine , demography , ethnic group , socioeconomic status , birth weight , population , cohort , pediatrics , pregnancy , environmental health , sociology , biology , anthropology , genetics
We evaluated early lactation success in a multi‐ethnic cohort of 448 primiparas in Sacramento, CA. Key outcomes were sub‐optimal infant breastfeeding behavior (SIBB), onset of stage II lactogenesis >72 h postpartum (delayed OL) and excess neonatal weight loss ( > 10% of birth weight by 70‐98 h). Prevalence of SIBB was 69% at 2‐46 h, 34% at 3‐4 d, and 24% at 1 wk of age, and did not differ by maternal ethnicity, age, income group or education. Delayed OL occurred in 42% of women (34% of African‐Americans, 40% of Hispanics, and 44% of non‐Hispanic whites and Asian‐Americans); it was more common in women > 30 y of age than in those < 30 y (56% vs. 37%, p=0.0004), and in those with some vs. no college education (47% vs. 36%, p=0.03). Excess neonatal weight loss (excluding infants who received > 60 mL of formula at 0‐48 h) occurred in 18% and was more common in infants of mothers with higher age (28% if > 30 y vs. 14% if < 30 y, p=0.01), income (22% vs. 12%, p=0.048) and education (22% vs. 10%, p=0.03); differences across ethnic groups were marginally significant (8% of African‐Americans, 11% of Hispanics, 18% of non‐Hispanic whites and 31% of Asian‐Americans; p=0.08). We conclude that early breastfeeding problems such as delayed OL have reached epidemic proportions in this population of primiparas, especially among women with greater age and education. Further analyses will explore the biological and behavioral underpinnings for these findings. Supported by a grant from the Department of Health and Human Services, Maternal Child Health Branch.