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.
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
©2013 by Walter de Gruyter Berlin Boston