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Licensed Unlicensed Requires Authentication Published by De Gruyter October 25, 2012

Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study

  • Tabea Gubler , Franziska Krähenmann , Malgorzata Roos , Roland Zimmermann and Nicole Ochsenbein-Kölble EMAIL logo

Abstract

Aims: Breastfeeding significantly benefits mothers and infants. We aimed to identify the determinants of its successful initiation.

Methods: A retrospective study of 1893 mothers delivering healthy term singletons at a Swiss university hospital from 1/2008 to 3/2009 determined the associations between multiple breastfeeding and early postpartum parameters by univariate and multiple regression analysis.

Results: Multiparity was associated with nursing exclusively at the breast at discharge (P<0.001), less use of maltodextrin supplement (P<0.05), bottle/cup (both P<0.001), but more pacifier use (P<0.05). Among obese mothers, nursing exclusively at the breast at discharge was less frequent, and use of all feeding aids more frequent, than among normal-weight women (both P<0.001). Neuraxial anesthesia was associated with use of maltodextrin and bottle (both P<0.05) compared to no anesthesia. Delayed first skin-to-skin contact and rooming-in for <24 h/day were each associated with maltodextrin and cup (P<0.05). Nursing exclusively at the breast at discharge was less frequent (P<0.001), and bottle use more frequent (P<0.05), in women with sore nipples than in those without.

Conclusions: Obesity is a potent inhibitor of breastfeeding initiation. Delivery without anesthesia by a multiparous normal-weight mother, followed by immediate skin-to-skin contact, rooming-in for 24 h/day, and dedicated nipple care, provides the best conditions for successful early postpartum breastfeeding without the need for feeding aids or nutritional supplements.


Corresponding author: Nicole Ochsenbein-Kölble, Obstetric Research Unit, Department of Obstetrics, Zurich University Hospital, Frauenklinikstr. 10, CH-8091 Zurich, Switzerland, Tel.: +41-1-255-5101, Fax: +41-1-255-5107

The authors stated that there are no conflicts of interest regarding the publication of this article.

References

[1] Ahluwalia IB, Morrow B, Hsia J. Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System. Pediatrics. 2005;116:1408–12.10.1542/peds.2005-0013Search in Google Scholar

[2] Amir LH, Donath S. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC Pregnancy Childbirth. 2007;7:9.10.1186/1471-2393-7-9Search in Google Scholar

[3] Anderson JW, Johnstone BM, Remley DT. Breast-feeding and cognitive development: a meta-analysis. Am J Clin Nutr. 1999;70:525–35.10.1093/ajcn/70.4.525Search in Google Scholar

[4] Baker JL, Gamborg M, Heitmann BL, Lissner L, Sørensen TI, Rasmussen KM. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr. 2008;88:1543–51.10.3945/ajcn.2008.26379Search in Google Scholar

[5] Blair A, Cadwell K, Turner-Maffei C, Brimdyr K. The relationship between positioning, the breastfeeding dynamic, the latching process and pain in breastfeeding mothers with sore nipples. Breastfeed Rev. 2003;11:5–10.Search in Google Scholar

[6] Breastfeeding Section on Collaborators, Johnston M, Landers S, Noble L, Szucs K, et al. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827–41.10.1542/peds.2011-3552Search in Google Scholar

[7] Chang ZM, Heaman MI. Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding. J Hum Lact. 2005;21:305–14; quiz 15-9, 26.Search in Google Scholar

[8] Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in the United States. Pediatrics. 2004;113:e435–9.10.1542/peds.113.5.e435Search in Google Scholar

[9] Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360:187–95.10.1016/S0140-6736(02)09454-0Search in Google Scholar

[10] Cope MB, Allison DB. Critical review of the World Health Organization’s (WHO) 2007 report on ‘evidence of the long-term effects of breastfeeding: systematic reviews and meta-analysis’ with respect to obesity. Obes Rev. 2008;9:594–605.10.1111/j.1467-789X.2008.00504.xSearch in Google Scholar PubMed

[11] Cramton R, Zain-Ul-Abideen M, Whalen B. Optimizing successful breastfeeding in the newborn. Curr Opin Pediatr. 2009;21:386–96.10.1097/MOP.0b013e32832b325aSearch in Google Scholar PubMed

[12] Dennis CL. Breastfeeding initiation and duration: a 1990–2000 literature review. J Obstet Gynecol Neonatal Nurs. 2002;31: 12–32.10.1111/j.1552-6909.2002.tb00019.xSearch in Google Scholar PubMed

[13] DiGirolamo A, Thompson N, Martorell R, Fein S, Grummer-Strawn L. Intention or experience? Predictors of continued breastfeeding. Health Educ Behav. 2005;32:208–26.10.1177/1090198104271971Search in Google Scholar PubMed

[14] Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics. 2010;126:e18–25.10.1542/peds.2008-3256Search in Google Scholar PubMed

[15] Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al. Breastfeeding and the use of human milk. Pediatrics. 2005;115:496–506.10.1542/peds.2004-2491Search in Google Scholar PubMed

[16] Hilson JA, Rasmussen KM, Kjolhede CL. Excessive weight gain during pregnancy is associated with earlier termination of breast-feeding among White women. J Nutr. 2006;136:140–6.10.1093/jn/136.1.140Search in Google Scholar PubMed

[17] Institute of Medicine (US) and National Research Council (US) Committee to Reexamine IOM Pregnancy Weight Guidelines. Weight gain during pregnancy: reexamining the guidelines. Approaches to achieving recommended gestational weight gain. In: Rasmussen KM, Yaktine AL, editors. Washington, DC: National Academies Press; 2009.Search in Google Scholar

[18] Karabulut E, Yalçin SS, Ozdemir-Geyik P, Karaağaoğlu E. Effect of pacifier use on exclusive and any breastfeeding: a meta-analysis. Turk J Pediatr. 2009;51:35–43.Search in Google Scholar

[19] Katz KA, Nilsson I, Rasmussen KM. Danish health care providers’ perception of breastfeeding difficulty experienced by women who are obese, have large breasts, or both. J Hum Lact. 2010;26:138–47.10.1177/0890334409349805Search in Google Scholar PubMed

[20] La Coursiere DY, Baksh L, Bloebaum L, Varner MW. Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J. 2006;10:385–90.10.1007/s10995-006-0075-1Search in Google Scholar PubMed

[21] Li DK, Willinger M, Petitti DB, Odouli R, Liu L, Hoffman HJ. Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): population based case-control study. Br Med J. 2006;332:18–22.10.1136/bmj.38671.640475.55Search in Google Scholar PubMed PubMed Central

[22] Merten S, Dratva J, Ackermann-Liebrich U. Do baby-friendly hospitals influence breastfeeding duration on a national level? Pediatrics. 2005;116:e702–8.10.1542/peds.2005-0537Search in Google Scholar PubMed

[23] Mok E, Multon C, Piguel L, Barroso E, Goua V, Christin P, et al. Decreased full breastfeeding, altered practices, perceptions, and infant weight change of prepregnant obese women: a need for extra support. Pediatrics. 2008;121: e1319–24.10.1542/peds.2007-2747Search in Google Scholar PubMed

[24] Moore ER, Anderson GC. Randomized controlled trial of very early mother-infant skin-to-skin contact and breastfeeding status. J Midwifery Womens Health. 2007;52:116–25.10.1016/j.jmwh.2006.12.002Search in Google Scholar PubMed

[25] Nysaether H, Baerug A, Nylander G, Klepp KI. Rooming-in in the maternity ward — are mothers satisfied? Tidsskr Nor Laegeforen. 2002;122:1206–9.Search in Google Scholar

[26] O’Connor NR, Tanabe KO, Siadaty MS, Hauck FR. Pacifiers and breastfeeding: a systematic review. Arch Pediatr Adolesc Med. 2009;163:378–82.10.1001/archpediatrics.2008.578Search in Google Scholar

[27] Parikh NI, Hwang SJ, Ingelsson E, Benjamin EJ, Fox CS, Vasan RS, et al. Breastfeeding in infancy and adult cardiovascular disease risk factors. Am J Med. 2009;122:656–63.10.1016/j.amjmed.2008.11.034Search in Google Scholar

[28] Parsons TJ, Power C, Logan S, Summerbell CD. Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord. 1999;23:S1–107.Search in Google Scholar

[29] Rasmussen KM, Hilson JA, Kjolhede CL. Obesity may impair lactogenesis II. J Nutr. 2001;131:3009S–11S.10.1093/jn/131.11.3009SSearch in Google Scholar

[30] Rasmussen KM, Kjolhede CL. Prepregnant overweight and obesity diminish the prolactin response to suckling in the first week postpartum. Pediatrics. 2004;113:e465–71.10.1542/peds.113.5.e465Search in Google Scholar

[31] Rosenblatt KA, Thomas DB. Lactation and the risk of epithelial ovarian cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Int J Epidemiol. 1993;22:192–7.Search in Google Scholar

[32] Rowe-Murray HJ, Fisher JR. Baby friendly hospital practices: cesarean section is a persistent barrier to early initiation of breastfeeding. Birth. 2002;29:124–31.10.1046/j.1523-536X.2002.00172.xSearch in Google Scholar

[33] Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old. Lancet. 1995;346:1065–9.10.1016/S0140-6736(95)91742-XSearch in Google Scholar

[34] UNICEF/WHO. Baby-friendly hospital initiative: revised, updated and expanded for integrated care. Section 1, Background and implementation. 1st ed. Geneva: WHO Document Production Services; 2009.Search in Google Scholar

[35] WHO. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals; 2009.Search in Google Scholar

[36] WHO, Expert Committee on Physical Status. The use and interpretation of anthropometry: report of a WHO expert committee. Geneva, Switzerland: World Health Organization; 1995.Search in Google Scholar

[37] Wiklund I, Norman M, Uvnäs-Moberg K, Ransjö-Arvidson AB, Andolf E. Epidural analgesia: breast-feeding success and related factors. Midwifery. 2009;25:e31–8.10.1016/j.midw.2007.07.005Search in Google Scholar PubMed

[38] Zimmermann R, Blöchlinger B, Kurmanavicius J. The electronic maternity notes. Gynäkologe. 2006;39:278–82.10.1007/s00129-006-1812-7Search in Google Scholar

Received: 2012-5-11
Accepted: 2012-9-27
Published Online: 2012-10-25
Published in Print: 2013-05-01

©2013 by Walter de Gruyter Berlin Boston

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