Early Lactation Success in a Multi-Ethnic Population
Project Number: R40 MC 04294-04 Project Date: 01/01/2005 Grantee: University of California, Davis Department/Center: Department of Nutrition
Final Report
Pending
Principal Investigator
Kathryn Dewey PhD, Professor, University of California, Davis Department of Nutrition, 1 Shields Avenue Davis, CA 95616-8669 kgdewey@ucdavis.edu
Abstract
Increasing the duration of exclusive breastfeeding is a health priority in the U.S., because of the many health benefits for mothers and infants. Campaigns to encourage mothers to attempt breastfeeding have resulted in increased rates of breastfeeding initiation, but the percentage predominantly breastfeeding at 10 wk postpartum has not improved. A major reason for this is that many mothers who initiate breastfeeding begin to supplement with formula or cease breastfeeding entirely within the first few weeks due to lactation difficulties. Thus, the most urgent need is to ensure that mothers who attempt breastfeeding are able to overcome these barriers. In a cohort of 280 predominantly Caucasian women who were highly motivated to breastfeed, the investigators found that more than 80% encountered problems during the first week postpartum such as delayed onset of milk production, sub-optimal infant breastfeeding behavior, or sore/cracked nipples. The investigators predict that these problems are at least as common in other ethnic groups, and that their effect on rates of exclusive breastfeeding are particularly strong among women with lower motivation to breastfeed. The specific aims are to: 1) compare the Incidence of early breastfeeding problems among primiparous African-American, Hispanic and non-Hispanic white women; 2) identify risk factors associated with delayed onset of milk production, sub-optimal infant breastfeeding behavior and sore nipples, with a focus on factors such as maternal and infant stress during labor and delivery, maternal overweight, infant characteristics and feeding patterns; and 3) assess factors associated with exclusive breastfeeding at I mo postpartum within each of the three main ethnic groups, with a focus on the interaction between two key sets of potential predictors: a. prenatal breastfeeding intentions and self-efficacy, and b. breastfeeding problems during the first week postpartum. This will be a multi-ethnic prospective study of 660 urban mother-infant pairs in Sacramento, CA. Mothers will be recruited prenatally and interviewed within 24 hours of giving birth (considered "day 0") as well as on days 3, 7, 14, 30 and 60 postpartum. The long-term goal is to develop culturally appropriate, evidence-based strategies to reduce the incidence of breastfeeding problems and assist mothers to breastfeed exclusively.
