Background
Primiparous women are at-risk for early, unintended breastfeeding reduction and cessation. Breastfeeding patterns that contribute to these outcomes require further exploration.
Research Aim/Questions
To describe early, “real time” breastfeeding behaviors and perceived problems of primiparous women.
Methods
First-time mothers intending to exclusively breastfeed downloaded a commercial infant feeding app during their postpartum hospitalization. Women logged feedings and their breastfeeding experiences, as they occurred, through eight weeks postpartum. Additional feeding and background data were collected via EMR and questionnaires administered at enrollment, two, and eight weeks postpartum. Summary statistics were compiled to examine weekly breastfeeding behaviors and problems.
Results
In this sample of 61 primarily highly-educated, White women committed to breastfeeding, 38% (n=23) used formula during the postpartum hospitalization and 68% (n=34) used formula at least once by two weeks. Nine women stopped breastfeeding during the study. Women using any formula in the hospital and those with less positive baseline attitudes toward breastfeeding were less likely to be exclusively breastfeeding at two and eight weeks, respectively (p<0.05). There was a trend toward declining at-breast feeds and high rates of milk expression during the study. Breastfeeding problems peaked at Week 2, with 81% of women (n=39) endorsing at least one problem at that time. The most prevalent problems included perception of inadequate milk, pain, latching, and inefficient feeds.
Conclusions
Interventions to address suboptimal breastfeeding in primiparous women should consider the pervasiveness of early milk expression and in-hospital formula supplementation in this population, as well as the trajectory of common problems.