Premium
Risk factors for delayed onset of lactogenesis among northern California primiparous women
Author(s) -
NommsenRivers Laurie Ann,
Cohen Roberta J,
Chantry Caroline J,
Peerson Janet M,
Dewey Kathryn G
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.344.8
Subject(s) - medicine , breastfeeding , logistic regression , birth weight , body mass index , obstetrics , demography , pregnancy , pediatrics , sociology , biology , genetics
Our objective was to determine factors associated with delayed onset of lactogenesis (delayed OL)‐defined as onset of stage II lactogenesis after 72 h postpartum (pp)‐among a multi‐ethnic sample of primiparae who initiated breastfeeding (N=415). Prevalence of delayed OL was 42%. Variables associated with delayed OL (P < .10, unadjusted) were greater maternal age, education level, and body mass index (BMI), Cesarean delivery, birth weight > 3600 g, lower Apgar scores, edema pp, formula intake > 60 ml over first 48 h, and lack of nipple pain at 24 or 72 h pp. A hierarchical series of multiple variable logistic regression models wasere used to examine independent effects of the above variables on the risk of delayed OL. The final model included the following significant (P < .05, adjusted) variables: maternal age, BMI, birth weight and formula use. There was a strong association between higher BMI and increased risk of edema (P < .0001); edema was significant in an alternate final model excluding BMI. DFurthermore, delayed OL increased the risk of excess neonatal weight loss (loss > 10% of birth weight): prevalence was 34.2% versus 7.8% among infants of mothers with vs.ersus without delayed OL (P< .0001). We conclude that delayed OL is common among this sample of California primiparae and is associated with both biological and behavioral factors. Supported by a grant from the Department of Health and Human Services, Maternal Child Health Bureau.