Delayed onset of lactation and risk of ending full breast-feeding early in rural guatemala

Daniel Hruschka, Daniel W. Sellen, Aryeh D. Stein, Reynaldo Martorell

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Mothers of infants (n = 328) born between 1996 and 1999 in four Guatemalan communities were interviewed every 2 wk until 6 mo postpartum (pp) to collect prospective breast-feeding data and assess the association between delayed (>3 d pp) onset of lactation (OL) and the risk of ending full breast-feeding. Cox proportional hazards regression was used to examine the association between delayed OL and the hazard of ending full breast-feeding in the first 6 mo, adjusted for potential confounders and effect modifiers. A significant interaction with community was found (community-specific hazard ratios: HRA = 2.87, 95% Cl = 1.25, 6.60; HRB = 3.43, 95% Cl = 1.55, 7.59; HRC = 0.26, 95% Cl = 0.06, 1.14; HRD = 1.11, 95% Cl = 0.44, 2.77). Supplementation before OL (preonset supplementation) was associated with delayed OL [odds ratio (OR) = 4.87, 95% Cl = 2.29, 10.36] and an increased risk of ending full breast-feeding (HR = 1.49, 95% Cl = 1.05, 2.11). In the two communities in which mothers who experienced delayed OL had a significantly greater risk of ending full breast-feeding than did mothers experiencing normal OL, the association between delayed OL and full breast-feeding was mediated in part by preonset supplementation. Further analyses suggest that this was due to delayed OL leading to nonbreast milk feeds, rather than to introduction of supplements delaying OL. We conclude that some mothers who experience delayed OL are less likely to continue full breast-feeding in the first 6 mo and that further research should examine the contextual factors that modify this relationship.

Original languageEnglish (US)
Pages (from-to)2592-2599
Number of pages8
JournalJournal of Nutrition
Volume133
Issue number8
StatePublished - Aug 1 2003
Externally publishedYes

Fingerprint

Guatemala
breast feeding
Breast Feeding
Lactation
lactation
Mothers
Postpartum Period
odds ratio
Milk
Odds Ratio

Keywords

  • Full breast-feeding
  • Lactogenesis
  • Onset of lactation
  • Predominant breast-feeding
  • Survival analysis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Delayed onset of lactation and risk of ending full breast-feeding early in rural guatemala. / Hruschka, Daniel; Sellen, Daniel W.; Stein, Aryeh D.; Martorell, Reynaldo.

In: Journal of Nutrition, Vol. 133, No. 8, 01.08.2003, p. 2592-2599.

Research output: Contribution to journalArticle

Hruschka, D, Sellen, DW, Stein, AD & Martorell, R 2003, 'Delayed onset of lactation and risk of ending full breast-feeding early in rural guatemala', Journal of Nutrition, vol. 133, no. 8, pp. 2592-2599.
Hruschka, Daniel ; Sellen, Daniel W. ; Stein, Aryeh D. ; Martorell, Reynaldo. / Delayed onset of lactation and risk of ending full breast-feeding early in rural guatemala. In: Journal of Nutrition. 2003 ; Vol. 133, No. 8. pp. 2592-2599.
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