New York University Steinhardt School of Culture, Education, and Human Development, New York, NY10003, USA.
University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
Public Health Nutr. 2021 Apr;24(5):935-941. doi: 10.1017/S1368980020001482. Epub 2020 Aug 4.
To test whether perception of insufficient milk (PIM) supply in the breast-feeding relationship of one child predicts how long mothers breast-feed subsequent children, and whether this association differs for first-time mothers v. mothers with previous children.
Secondary analysis of Infant Feeding Practices Study II (ordinary least squares regression) and Year 6 follow-up.
Mailed, self-report survey of US mother-infant dyads, 2005-2012.
Women pregnant with a singleton were recruited from a consumer opinion panel. Exclusion criteria included: mother age <18; infant born <5 lbs, born before 35 weeks or with extended NICU stay, and mother or infant diagnosed with condition that impacts feeding. A subsample with PIM data (n 1460) was analysed.
We found that women who weaned because of PIM with the index child stopped breast-feeding 5·7 weeks earlier than those who weaned due to other reasons (4·9 weeks earlier for multiparas, P < 0·001; 7·1 weeks earlier for primiparas, P < 0·001). Using Year 6 follow-up data (n 350), we found subsequent child 1 weaned 9·2 weeks earlier if the mother experiences PIM as a multipara (P = 0·020) and 10·6 weeks earlier if the mother experiences PIM as a primipara (P = 0·019). For subsequent child 2 (n 78), the magnitude of association was even larger, although insignificant due to low power.
These findings indicate that PIM may carry forward in the reproductive life course, especially for first-time mothers. Perceptions of breast milk insufficiency and contributors to actual inadequate milk supply with the first child should be targeted, rather than intervening later in the reproductive life course.
检验一个孩子母乳喂养关系中感知母乳不足（PIM）是否会影响母亲后续哺乳的时间，以及这种关联是否因初产妇和有既往生育史的产妇而有所不同。
婴儿喂养实践研究 II 的二次分析（最小二乘法回归）和 6 年随访。
美国母婴对子的邮寄、自我报告调查，2005-2012 年。
从消费者意见小组中招募了怀有单胎的女性。排除标准包括：母亲年龄<18 岁；婴儿出生体重<5 磅，出生<35 周或有延长的新生儿重症监护病房停留时间，以及母亲或婴儿被诊断为影响喂养的疾病。对有 PIM 数据的亚组（n=1460）进行了分析。
我们发现，由于 PIM 而给索引孩子断奶的女性比因其他原因断奶的女性早 5.7 周停止母乳喂养（多产妇早 4.9 周，P<0.001；初产妇早 7.1 周，P<0.001）。使用 6 年随访数据（n=350），我们发现如果母亲是多产妇经历 PIM，后续孩子 1 会早 9.2 周断奶（P=0.020），如果母亲是初产妇经历 PIM，后续孩子 1 会早 10.6 周断奶（P=0.019）。对于后续孩子 2（n=78），尽管由于样本量小，关联的幅度更大，但没有统计学意义。
这些发现表明，PIM 可能在生殖生命历程中延续，特别是对于初产妇。应针对第一个孩子的母乳不足感知及其导致实际母乳不足的因素进行干预，而不是在生殖生命历程后期进行干预。
