title: Delayed onset lactogenesis II predicts the cessation of any or exclusive breastfeeding.
abstract: OBJECTIVE
  To evaluate the association between delayed lactogenesis II (>3 days postpartum; delayed onset lactogenesis II [DLII]) and the cessation of any and exclusive breastfeeding at 4-weeks postpartum.
  
  
  METHODS
  We constructed multivariable logistic regression models using data from 2491 mothers enrolled in the prospective Infant Feeding Practice Study II cohort. Models included DLII, known risk factors for breastfeeding cessation (age, education, race, parity/previous breastfeeding, and exclusive breastfeeding plan), and potential confounders identified in bivariate analyses (P ≤ .1). Backward selection processes (P ≤ .1) determined risk factor retention in the final model.
  
  
  RESULTS
  DLII was associated with cessation of any and exclusive breastfeeding at 4-weeks postpartum (OR 1.62; CI 1.14-2.31; OR 1.62; CI 1.18-2.22, respectively); numerous independent risk factors qualified for inclusion in the multivariable model(s) and were associated with the outcome(s) of interest (eg, supplemental nutrition program for women, infants, and children enrollment, onset of prenatal care, feeding on-demand, time initiated first breastfeed, hospital rooming-in, obstetric provider preference for exclusive breastfeeding, and maternal tobacco use).
  
  
  CONCLUSIONS
  Women experiencing DLII may be less able to sustain any and/or exclusive breastfeeding in the early postpartum period. Routine assessment of DLII in postpartum breastfeeding follow-up is warranted. Women with DLII may benefit from additional early postpartum interventions to support favorable breastfeeding outcomes.
authors.affiliation: Department of Research, Connecticut Children's Medical Center, Hartford, CT 06106, USA. EBrownell@CCMCKids.org
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brownell
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Howard
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Lawrence
authors.forename: Ann M
authors.initials: AM
authors.lastname: Dozier
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D005260:Female; D015438:Health Behavior; D006801:Humans; D007774:Lactation / Q000502:physiology*; D015999:Multivariate Analysis; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult