Neonatologist Clinica y Maternidad Suizo Argentina Clinica y Maternidad Suizo Argentina Buenos Aires, Ciudad Autonoma de Buenos Aires, Argentina
Background: Breastfeeding difficulties may occur in the first days of life and most of the issues can be solved with the appropriate assessment. To characterize our population we conducted a prospective, observational study in which we scheduled post-discharge interviews with all the mothers giving birth between 9/25 and12/31, 2017.
Objective: Our objective was to classify breastfeeding issues and describe their distribution among dyads assessed by lactation consultants during the study period.
Design/Methods: All mothers of babies born ≥37 weeks of gestational age signed informed consent to be assessed 24 to 72 h after discharge by a lactation consultant. Breastfeeding problems were coded into the categories: A) Mother issues (1: Mastitis; 2: Incorrect information; 3: Mammary reduction; 4: Maternal mismanagement; 5: Umbilicated / flat / retractable nipple; 6: Nipple cracks; 7: Duct clogging; 8: Primary mammary congestion; 9: Low milk production; 10: Excessive ejection); B) Baby issues (1: Undemanding; 2: Oral thrush; 3: Frenulum; 4: Weak suction; 5: Tongue up-tilt); C) Technique issues (1: Weaning; 2: Back to breastfeeding; 3: General latching issues); and D) Other issues (1: Back to work; 2: Simultaneous latching; 3: Other). If no issue was found, “no issue” was coded. Crude analysis and by delivery mode (DM), maternal age (MA), time to discharge (TTD) and gestational age at birth (GAB) were performed. Each breastfeeding issue was compared against its negative in each group by Chi2 test.
Results: 1249 mothers of 1252 babies were summoned and 564 babies (45.1%) underwent further assessment. Baseline features of the population are shown in Table 1. One hundred and seventy of them showed no breastfeeding issues. Among the remaining 394, 564 breastfeeding problems were found (Fig. 1). Distribution of breastfeeding issues is shown in Table 2. Maternal cause accounted for 68.9% of all the issues, being the most relevant: primary mammary congestion (29.6%), nipple cracks (18.1%) and general latching (13.3%). Conclusion(s): More than 2/3 of all breastfeeding issues were due to maternal causes. Primary mammary congestion, nipple cracks and general latching issues, accounted for ~61% of all problems. Main lactation problems detected in the study may be preventable by education of women during pregnancy and support of parents by experienced personnel during the hospital stay and the first few days after discharge.
Table 1. Baseline characteristics of the population
Table 2. Distribution of breastfeeding difficulties
Figure 1. Patient inclusion flowchart
Authors/Institutions: Joaquin Pedre, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Johanna Lamas, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Evelyn Pesce, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Marcela F. Sanchez, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Ana L. Santagada, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Ana m. Pedraza, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina; Luis Prudent, Clinica y Maternidad Suizo Argentina, Buenos Aires, , Argentina