Identification of risk factors for delayed onset of lactation.
OBJECTIVE
To identify infant feeding, socioeconomic, demographic, and delivery-related factors that affect women's self-reported timing of the onset of lactation.


METHODS
Longitudinal survey of women from day 1 postpartum until self-reported onset of lactation. Subjects were interviewed in person on day 1 postpartum, then surveyed daily by telephone regarding infant feeding method, breast symptoms, and perception of whether the onset of lactation had occurred. Medical records were reviewed.


METHODS
Data were collected from 192 women after they gave birth to a healthy, term singleton.


METHODS
chi 2 Analyses were used to identify variables associated with delayed onset of lactation (onset of lactation > or = 72 hours postpartum). Multivariate logistic regression was used to identify the independent association of each significant variable with delayed onset of lactation.


RESULTS
Risk factors for delayed onset of lactation included white/Hispanic ethnicity, heavy/obese body build, delivery of offspring by unscheduled cesarean delivery, vaginal delivery with prolonged stage 2 labor, infant birth weight less than 8 lb, and exclusive formula-feeding before the onset of lactation.


CONCLUSIONS
Women who are at risk for delayed onset of lactation need additional breast-feeding support during the first week postpartum. During their hospitalization, these women should be instructed about the normal lactation process and the possibility that onset of lactation may occur later than 72 hours postpartum. Frequent nursing should be recommended, as delayed onset of lactation was associated with the lack of infant suckling.
Chapman
D J
DJ
Department of Nutritional Sciences, University of Connecticut, Storrs 06269-4017, USA.
Pérez-Escamilla
R
R
D000328:Adult; D001724:Birth Weight; D001940:Breast / Q000502:physiology; D001942:Breast Feeding; D002585:Cesarean Section / Q000009:adverse effects; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007748:Labor Stage, Second / Q000502:physiology; D007774:Lactation / Q000502:physiology*; D007775:Lactation Disorders / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology*; D016015:Logistic Models; D008137:Longitudinal Studies; D009765:Obesity / Q000150:complications; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D044465:White People