Correlates of lactation in mothers of very low birth weight infants.
OBJECTIVE
We sought to determine the correlates of intent to breastfeed and of successful lactation and nursing at the breast in mothers of very low birth weight (VLBW; <1.5 kg) infants.


METHODS
We conducted a prospective observational study of 119 mothers of singleton VLBW infants (mean birth weight: 1056 g; mean gestational age: 28 weeks), 87 (73%) of whom intended to breastfeed. Mothers completed questionnaires at 3 weeks' postnatal age and at 35 and 40 weeks' (term) and 4 months' corrected ages (CAs).


RESULTS
Of the 87 mothers who intended to breastfeed, 30 mothers (34%) continued lactation beyond 40 weeks' CA (postmenstrual plus postnatal age). Compared with mothers who discontinued lactation before this time, those who continued were older (31 vs 26 years), more were married (80% vs 39%), they had more than a high school education (70% vs 42%), and they were white (63% vs 35%). There were no significant differences in their infants' birth data or rates of neonatal morbidity. Significant correlates of lactation beyond 40 weeks' CA included beginning milk expression before 6 hours postdelivery, expressing milk > or =5 times per day, and kangaroo care. These correlates remained significant after controlling for maternal age, race, marital status, and education beyond high school. At 4 months' CA, 14 mothers (16%) were still lactating, 12 of whom were nursing at the breast.


CONCLUSIONS
Increased maternal support specifically directed toward behavioral factors, including early and more frequent milk expression and kangaroo care, may improve the rates of successful lactation among mothers of VLBW infants who choose to breastfeed.
Furman
Lydia
L
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA. lmfurman@att.net
Minich
Nori
N
Hack
Maureen
M
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D019052:Depression, Postpartum / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007774:Lactation / Q000502:physiology*; D008423:Maternal Age; D009820:Ohio / Q000453:epidemiology; D011446:Prospective Studies; D012044:Regression Analysis; D012923:Social Class; D014931:Women, Working / Q000706:statistics & numerical data