Flaherman Valerie J, Beiler Jessica S, Cabana Michael D, Paul Ian M
Department of Pediatrics, School of Medicine, University of California, San Francisco, California, USA.
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, California, USA.
Matern Child Nutr. 2016 Jul;12(3):463-72. doi: 10.1111/mcn.12171. Epub 2015 Mar 18.
Milk supply concern is the most common reason for breastfeeding discontinuation and maternal anxiety is also associated with reduced breastfeeding duration. Newborn excess weight loss (EWL) could trigger milk supply concern and anxiety and might be amenable to modification. Our objective was to determine the relationship between EWL and the development of milk supply concern and anxiety and the effect of such development on breastfeeding duration. We conducted a cohort analysis using data previously obtained from a randomised controlled trial comparing two post-hospital discharge follow-up strategies. For 1107 well, singleton infants born at ≥34 weeks, we extracted data on all inpatient infant weights. EWL was defined as the loss of ≥10% of birthweight. We surveyed mothers to obtain data on state anxiety and milk supply concern at birth and at 2 weeks. Our final outcome was breastfeeding at 6 months. Seventy (6.3%) infants developed EWL during the birth hospitalisation. At 2 weeks, milk supply concern and positive anxiety screen were more common (42% and 18%, respectively) among mothers whose infants had had EWL than among mothers whose infants had not had EWL (20% and 6%, respectively) (P < 0.001 for each comparison). Mothers with milk supply concern at 2 weeks were much less likely to be breastfeeding at 6 months, with odds ratio of 0.47 (0.30, 0.74) in multivariate analysis. EWL may increase milk supply concern and anxiety and these may reduce breastfeeding duration. Ameliorating EWL might alleviate milk supply concern and anxiety and improve breastfeeding duration.
乳汁供应问题是停止母乳喂养最常见的原因，而母亲的焦虑也与母乳喂养持续时间缩短有关。新生儿体重过度减轻（EWL）可能引发乳汁供应问题和焦虑，并且可能可以加以改善。我们的目的是确定EWL与乳汁供应问题及焦虑的发生之间的关系，以及这种情况对母乳喂养持续时间的影响。我们使用先前从一项比较两种出院后随访策略的随机对照试验中获得的数据进行了队列分析。对于1107名孕龄≥34周出生的健康单胎婴儿，我们提取了所有住院期间婴儿体重的数据。EWL定义为出生体重减轻≥10%。我们对母亲进行了调查，以获取出生时和2周时关于状态焦虑和乳汁供应问题的数据。我们的最终结局是6个月时的母乳喂养情况。70名（6.3%）婴儿在出生住院期间出现了EWL。在2周时，婴儿出现EWL的母亲中，乳汁供应问题和焦虑筛查呈阳性更为常见（分别为42%和18%），高于婴儿未出现EWL的母亲（分别为20%和6%）（每项比较P < 0.001）。在2周时有乳汁供应问题的母亲在6个月时进行母乳喂养的可能性要低得多，多变量分析中的优势比为0.47（0.30，0.74）。EWL可能会增加乳汁供应问题和焦虑，而这些可能会缩短母乳喂养持续时间。改善EWL可能会减轻乳汁供应问题和焦虑，并改善母乳喂养持续时间。
