Identification of Risk Factors for Delayed Onset of Lactation
Section snippets
Study Design
This longitudinal study followed up a convenience sample of 192 women recruited at Hartford Hospital (Hartford, Conn) on day 1 postpartum after delivery of a healthy, term singleton. The study was conducted between December 1996 and May 1997 and was approved by the human subjects committees at the University of Connecticut and Hartford Hospital. Our sampling goal was to recruit 100 primiparous women and 50 women who had had a cesarean delivery. On the 3 days per week during which subjects were
Results
The women in this study were primarily white, did not smoke, breast-fed their infants, had a prepregnancy body mass index less than 27, and on average had at least 2 years of college education (Table 1). The type of anesthesia received during vaginal delivery was as follows: none (4.3%), local (20.7%), epidural (75.0%). During cesarean delivery, women received a spinal (40.4%), epidural (51.9%), or general (7.7%) anesthetic. More than 75% of the women chose to breast-feed and were
Discussion
This article presents a comprehensive analysis of risk factors for delayed onset of lactation. Although other authors have evaluated individual factors that may affect the timing of onset of lactation (6), (17), it is difficult to make direct comparisons between our results and those of previous studies because of the unique nature of our study. Most of the other studies (6), (17) did not provide information on maternal body build, duration of labor, and infant birth weight, which were shown to
Applications
This research can be used to develop a profile of women at risk for delayed onset of lactation. Women at risk include those who undergo unscheduled cesarean delivery or a vaginal delivery with stage 2 labor that lasts more than 1 hour, are of heavy/obese body build, or give birth to an infant whose birth weight is less than 8 lb. During their postpartum hospitalization, these women should be provided with additional breast-feeding support and should be instructed about the normal lactation
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