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This study examined potential primary mediators, such as intended length to breastfeed, maternal education, income, and infant gestation, and secondary mediators, such as early frequency of breast stimulation, early milk output, and supplementation with artificial milks that may influence milk output in mothers of preterm and term infants the first 6 weeks postpartum. Analysis suggested that for mothers of a preterm infant (n = 95), the primary mediators, income and infant gestation, and the secondary mediators, early milk output/d and early frequency/d, accounted for 53.5% of the variance in milk output/d at week 6. For mothers of a term infant (n = 98), the primary mediator, income, and secondary mediators, early milk output/d and supplementation, accounted for 48.4% of the variance in milk output/d at week 6. Further research is needed to determine what early interventions may improve milk output in mothers at risk for lactation failure. [ABSTRACT FROM AUTHOR]

This secondary data analysis examined if time of initiation of milk expression and pumping frequency influenced milk weight weeks 2-5 postpartum. Of the 39 subjects in the convenience sample, 20 were in the early initiating (EI) group, (n = 12 high frequency [HF], n = 8 low frequency [LF] ), and 19 were in the late initiating (LI) group, (n = 7 HF, n = 12 LF). The EI group initiated pumping <_ 48 hours after birth; the HF group pumped a minimum of 6.25 times daily. A two-way analysis of variance indicated that milk weight was significantly higher in the HF as compared to the LF group. While there was no significant difference in milk weight between the El and LI groups, there was a significant interaction between frequency and initiation. Milk weight for the LF/EI group appeared to be positively influenced by the initiation of mechanical expression soon after birth. [ABSTRACT FROM AUTHOR]

Milk production was examined in 39 lactating mothers of non-nursing preterm infants from 2 tertiary care centers. The purposes of this study were (1) to compare milk production of those using sequential single (SEQ) or simultaneous double (SIM) breast-pumping regimen, and (2) to examine the relationship of selected variables to inadequate (< 3500 g/week) and adequate (> or = 3500 g/week) milk production. In multivariate analysis, mothers using SIM produced a similar amount of milk by weight during weeks 2 to 5 postpartum compared to those using SEQ. A logistic regression model including frequency of kangaroo care, frequency of pumping, high versus low income, and previous breastfeeding experience was predictive of mothers producing adequate versus inadequate milk volume 79% of the time. All of the mothers producing > 3500 g at week 2 produced adequate amounts of milk at weeks 4 and 5. None of the mothers producing < 1700 g at week 2 reached adequate production by weeks 4 and 5. Of the remaining mothers who produced 1700 g to 3500 g at week 2, 54% achieved adequate production during weeks 4 and 5 postpartum. [ABSTRACT FROM AUTHOR]

Sampling bias occurs in research when a large percentage of subjects who are eligible for the study refuse to participate. During Phase I of a two-phase multisite Mother-Baby Feeding Project, approximately 50% of the 235 potential participants at four of five sites declined to enter the study. This report compares subjects who fully participated with those who minimally participated and explores factors related to subjects' refusal to participate. Data regarding sociodemographic data, breast-feeding experience, and reason for refusal were collected from 92 subjects who declined to enter but agreed to minimally participate. The fully participating subjects had more education than those who participated minimally. However, the breast-feeding outcomes studied were similar for both groups. This provides support for generalizing additional study findings beyond the group of fully participating subjects when considering breast-feeding outcomes. Findings lend insight into the problem of subject recruitment that is not well-addressed in the nursing literature. [ABSTRACT FROM AUTHOR]

The objective of the study was to ascertain the nature of health professional contacts related to breastfeeding for 341 women. Subjects were prospectively queried by phone or home visit over a 20-week period regarding the number and nature of contacts with health care professionals related to breastfeeding. Lactation consultants gave significantly more positive encouragement (98%) (p = .01) than either nurses (75%) or physicians (68%) did. However, of the 233 health provider contacts that included breastfeeding advice, only 21% involved lactation consultants. Primiparae were likely to decrease their level of breastfeeding if a health professional encouraged supplemental foods (39%) or weaning (86%) during the prior week. Multiparae who were experienced at breastfeeding (3+ weeks breastfeeding the previous infant) decreased their breastfeeding slowly across the weeks with the current infant, and their level of breastfeeding in general appeared independent of health care provider advice. Multiparae who lacked previous sustained breastfeeding experience (0-3 weeks) had the most rapid decrease (65%) in their breastfeeding rates even with health care provider encouragement to continue. Thus, they too appeared to act independently of health care provider advice. [ABSTRACT FROM AUTHOR]

Mothers who must express milk for a prolonged period frequently report that milk volumes decrease. The purpose of this pilot study was to assess the feasibility of having a sample of lactating mothers of preterm infants follow a specific breast pumping protocol, express milk mechanically for six weeks, and have a subsample consent to venipuncture. This pilot study compared the effects of pumping breasts sequentially or simultaneously on milk volume and prolactin levels in mothers of preterm infants. Nine lactating mothers were randomly assigned to a sequential single or simultaneous double electric breast pumping system. Prolactin levels were examined in four mothers on days 21 and 42 postpartum. The sequential single and simultaneous double groups had mean baseline prolactin levels of 50.8 ng/ml and 40.6 ng/ml, respectively on day 21, and 26.6 ng/ml and 34.5 ng/ml, respectively, on day 42 postpartum. At 9 and 12 weeks postpartum mothers were queried about their lactational status. The results suggested that milk yield may be maintained or increased with frequent use of the simultaneous double pumping system. Further study is needed to confirm results of this pilot study. [ABSTRACT FROM AUTHOR]

For 14 days following birth, 114 breastfeeding mothers rated their level of breast engorgement twice daily, using a six-point engorgement scale. Individual engorgement ratings were plotted by intensity over time to provide a visual display of each subject's breast engorgement experience. Four distinct patterns of breast engorgement emerged; mothers experienced either a bell-shaped pattern, a multi-modal pattern, a pattern of intense engorgement, or a pattern of minimal engorgement. Characteristics of mothers and infants, and feeding frequency were similar across the four breast engorgement patterns. [ABSTRACT FROM AUTHOR]

This study describes breast engorgement during days 1-14 postpartum of 114 first and second time vaginal- and cesarean-delivery breastfeeding mothers. Most mothers reported experiencing their most intense engorgement after hospital discharge. Previous breastfeeding experience of the mother is a more critical variable than parity in predicting engorgement. Second time breastfeeding mothers experienced engorgement sooner and more severely than did first time breastfeeding mothers, regardless of delivery method. Anticipatory guidance by the care provider is discussed in an effort to enhance the experience of the breastfeeding dyad. [ABSTRACT FROM AUTHOR]

Sixty-four women of low socioeconomic status were interviewed in their third trimester and again six weeks postpartum. They were questioned about their infant feeding plans, general attitudes about breastfeeding, time of feeding decision, persons who influenced the infant feeding choice, and number of breastfeeding classes attended. Their knowledge of breastfeeding was measured by a questionnaire designed for this purpose. The choice of infant feeding method was influenced most by the mother itself. However, the subject's mother and the male partner were important influences. Mothers who breastfed were more likely to make their feeding decision before or very early in pregnancy than were mothers who bottle-fed. Maternal attitudes about breastfeeding also were more positive among breastfeeding women than among bottle-feeding women, and breastfeeding women attended more classes on this subject than their counterparts who bottle-fed. The role of education and follow-up by nurses is discussed. [ABSTRACT FROM AUTHOR]