I would encourage a day THREE bf assessment based on the research done by
- Jane Heinig, Kay Dewey and Laurie Nommsen-Rivers. They have been
published in various journals, (see below). I've heard them all speak at
various times. They conducted additional research at the same time that they
were gathering the WHO weight data in Davis, California.
This is one reason I arrange for an IBCLC Home Visit (using www.ilca.org
Find a Lactation Consultant and then checking credentials through
www.iblce.org) as my gift whenever I learn a friend's daughter (that I can't
visit myself) has had a baby...
Jeanette Panchula
California
From:
http://pediatrics.aappublications.org/cgi/content/abstract/112/3/607
PEDIATRICS Vol. 112 No. 3 September 2003, pp. 607-619
Risk Factors for Suboptimal Infant Breastfeeding Behavior, Delayed Onset of
Lactation, and Excess Neonatal Weight Loss
Kathryn G. Dewey, PhD, Laurie A. Nommsen-Rivers, MS, RD, IBCLC, M. Jane
Heinig, PhD, IBCLC and Roberta J. Cohen, PhD
From the Department of Nutrition, University of California, Davis, Davis,
California
--> Objective. Some mothers have difficulty initiating lactation even when
highly motivated to breastfeed. The purpose of this study was to determine
the incidence of and risk factors for suboptimal infant breastfeeding
behavior (SIBB), delayed onset of lactation, and excess neonatal weight loss
among mother-infant pairs in a population with high educational levels and
motivation to breastfeed.
Methods. All mothers residing in Davis, California, who gave birth to a
healthy, single, term infant at 1 of 5 area hospitals during the 10-month
recruitment period in 1999 were invited to participate if they were willing
to attempt to breastfeed exclusively for at least 1 month. Lactation
guidance was provided and data were collected in the hospital (day 0) and on
days 3, 5, 7, and 14. Infant breastfeeding behavior was evaluated by trained
lactation consultants using the Infant Breastfeeding Assessment Tool. Onset
of lactation was defined based on maternal report of changes in breast
fullness. Infant weight loss was considered excessive if it was 10% of birth
weight by day 3.
Results. Of the 328 eligible mothers, 280 (85%) participated in the study.
The prevalence of SIBB was 49% on day 0, 22% on day 3, and 14% on day 7.
SIBB was significantly associated with primiparity (days 0 and 3), cesarean
section (in multiparas, day 0), flat or inverted nipples, infant status at
birth (days 0 and 3), use of nonbreast milk fluids in the first 48 hours
(days 3 and 7), pacifier use (day 3), stage II labor >1 hour (day 7),
maternal body mass index >27 kg/m2 (day 7) and birth weight <3600 g (day 7).
Delayed onset of lactation (>72 hours) occurred in 22% of women and was
associated with primiparity, cesarean section, stage II labor >1 hour,
maternal body mass index >27 kg/m2, flat or inverted nipples, and birth
weight >3600 g (in primiparas). Excess weight loss occurred in 12% of
infants and was associated with primiparity, long duration of labor, use of
labor medications (in multiparas), and infant status at birth. The risk of
excess infant weight loss was 7.1 times greater if the mother had delayed
onset of lactation, and 2.6 times greater if the infant had SIBB on day 0.
Conclusions. Early lactation success is strongly influenced by parity, but
may also be affected by potentially modifiable factors such as delivery
mode, duration of labor, labor medications, use of nonbreast milk fluids
and/or pacifiers, and maternal overweight. All breastfeeding mother-infant
pairs should be evaluated at 72 to 96 hours' postpartum.
________________________________________________
Additional article published in 2004 Journal of Human Lactation:
http://jhl.sagepub.com/cgi/reprint/20/1/101
Early Breastfeeding Difficulties: Incidence and Risk Factors by Laurie
Nommsen-Rivers
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