ABSTRACT
Objective To explore the impact of postpartum fatigue on the onset of lactation.Methods Totally 553 mother-infant dyads were enrolled from three hospitals in Nantong City using sampling method of probability proportional to size.The timing of the onset of lactation,delayed onset of lactation and maternal postpartum fatigue were measured during the period of hospitalization.Postpartum fatigue was measured by Fatigue Scale-14.The timing of onset of lactation was determined by matemal perception of breast fullness.One-way analysis of variance was used to compare the difference of onset of lactation in four groups with varied fatigue scores.Impact of the maternal fatigue on the onset of lactation was analyzed by multiple linear regression.Results Mothers' fatigue score was related to the onset of lactation(r-0.15,P＜0.001).Mothers with postpartum fatigue scores ranging from 9 to 14 had delayed onset of lactation compared with those with fatigue score ranging from 0 to 3 and from 4 to 5,and the differences were significant (P=0.004),and the rate of delayed onset of lactation was increased (P=0.020).Postpartum fatigue was an independent risk factor,after controlling mode of delivery,mode of anesthesia,duration of infant sucking,maternal pain,and infant sucking gesture(t=3.26,P=0.001).Conclusion Postpartum fatigue is one of reasons leading to delayed onset of lactation.Health care providers and family members should pay more attention to postpartum fatigue and take effective measures to promote a successful onset of lactation and breastfeeding.
ABSTRACT
Objective To explore the correlation between gestational diabetes mellitus(GDM) and delayed onset of lactogenesis(DOL),providing references for prevention of DOL among gravidas with GDM.Methods From March to September 2016,gravidas in three tertiary hospitals in Nanjing for antenatal examination were screened for glucose tolerance,and 275 gravidas diagnosed with GDM were assigned into the GDM group,275 gravidas with normal glucose tolerance were assigned into the non-GDM group.Timing of maternal perception of onset of lactogenesis (OL) was recorded and breast milk postpartum 48h to 72h was collected for detecting lactose concentration.Chisquare test was used to compare rate of DOL in two groups,t-test was used to compare difference of lactose concentration between two groups,Pearson correlation was used to analyze the relationship of lactose concentration in breast milk and timing of OL,and multiple logistic regression model was used to analyze impact of GDM on DOL.Results Rate of DOL in the GDM group was higher than that in the non-GDM group,and the difference was statistically significant(P＜0.05).Lactose concentration in the GDM group was lower than that in the non-GDM group,and the difference was statistically significant(P＜0.05).There was a negative linear correlation between lactose concentration and timing of OL 48-72h after delivery.Primipara and GDM were risk factors of DOL.Conclusion Timing of OL among GDM puerperae is later than non-GDM puerperae,and GDM puerperae are at higher risk of DOL.More attention should be paid and measures should be taken for its prevention.
ABSTRACT
Objectives: The aim of the study was: (1) To know the frequency of suboptimal infant breastfeeding behavior (SIBB), delayed onset of lactation (DOL) and excess neonatal weight loss (EWL) in mother-infant pairs with a high motivation to breastfeed; (2) to see if SIBB influenced lactational problems represented by: a] DOL, b] EWL; (3) in addition, we have tried to assess the risk factors for SIBB and other risk factors for DOL and EWL. Material and methods: A longitudinal hospital-based observational study. Infant breastfeeding behavior was assessed by IBFAT score, DOL was measured by maternal perception of breast fullness and maternal motivation by an initial interview based on breastfeeding self-efficacy scale. Results: Frequency of SIBB was 13.3% on Day 0, 6.6% on Day 3 and 2.9% on Day 7. DOL occurred in 11.8% of mothers and excess weight loss in 17.7% of infants. Prolonged labor, medications given during labor, inadequacy of sleep during peripartum and use of supplementary feeds were found to be significantly associated with SIBB. Infants with SIBB on Day 0 were 17 times more likely to have SIBB on Day 3 and they were also four times more likely to have excess weight loss. Failure of exclusive breastfeeding (EBF) occurred in 8.1% and showed a significant association with SIBB, but at two weeks all were breastfeeding exclusively. Conclusion: Infant behavior plays an important role in the success of early breastfeeding and if suboptimal, contributes to failure of EBF. Both infant behavior and onset of lactation constitute significant predictors of excessive weight loss and short-term failure of exclusive breastfeeding and help in determining the need for intensive lactation counseling in high-risk cases.