title: Perceived breast milk insufficiency in mothers of neonates hospitalized in neonatal intensive care unit.
abstract: OBJECTIVE
  A) To study the frequency of perceived breast milk insufficiency in mothers of hospitalized neonates. b) To assess subsequent duration of exclusive breast feeding and growth (upto three months) in neonates whose mothers perceived breast milk insufficiency.
  
  
  METHODS
  Neonates whose mothers were willing to breastfeed their babies were included in the study. Their breastfeeding status was assessed and the mother's perception of breastfeeding was elicited as per WHO guidelines. In mothers who perceived breast milk insufficiency (crisis group), causes for such a perception were looked into. Mothers were regularly counseled to breastfeed the infant After discharge the mother infant dyad were followed up for three months and babies evaluated for weight, length and head circumference.
  
  
  RESULTS
  Three hundred and seven neonates and their mothers fulfilling the inclusion criteria were enrolled in the study. Perceived breast milk insufficiency was present in 208 (68%) mothers. Common reasons for such a perception were irrational. In the crisis group, 35% mothers had preterm babies as compared to 16% in the non crisis group (p =0.001). One hundred and fifty three mothers (73.33%) in the crisis group had breast milk sodium levels>16 mmol/L as compared to 12 mothers (12.12%) in the non crisis group (p 0.001). Micturition <6 times/24 hours was reported in 166 (83%) mothers in crisis group as compared to 18 (18.1%) mothers in non crisis group. All mothers who perceived breast milk insufficiency could be helped by lactation management and exclusively breastfed their babies. All infants were exclusively breastfed at discharge and at three month follow up. The growth of the infants was satisfactory in the crisis group at 3 months follow up.
  
  
  CONCLUSIONS
  The Present study suggests that lactation failure following delayed initiation of breastfeeding can be countered by subsequent intensive counselling. Emphasis is required on counselling for breastfeeding in primary neonatal care.
authors.affiliation: Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India. drnbmathur@vsnl.com
authors.forename: N B
authors.initials: NB
authors.lastname: Mathur
authors.forename: Dhulika
authors.initials: D
authors.lastname: Dhingra
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D002657:Child Development / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D015931:Intensive Care, Neonatal; D007775:Lactation Disorders / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008425:Maternal Behavior; D009034:Mother-Child Relations; D009751:Nutritional Requirements; D010465:Perception; D011247:Pregnancy; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D055815:Young Adult