Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis

Abstract

Background Breastfeeding difficulties frequently exacerbate one another and are common reasons for curtailed breastfeeding. Women with chronic conditions are at high risk of early breastfeeding cessation, yet limited evidence exists on the breastfeeding difficulties that co-occur in these mothers. The objective of this study was to explore clusters of breastfeeding difficulties experienced up to 6 weeks postpartum among mothers with chronic conditions and to examine associations between chronic condition types and breastfeeding difficulty clusters. Methods We analyzed 348 mothers with chronic conditions enrolled in a prospective, community-based pregnancy cohort study from Alberta, Canada. Data were collected through self-report questionnaires. We used latent class analysis to identify clusters of early breastfeeding difficulties and multinomial logistic regression to examine whether types of chronic conditions were associated with these clusters, adjusting for maternal and obstetric factors. Results We identified three clusters of breastfeeding difficulties. The “physiologically expected” cluster (51.1% of women) was characterized by leaking breasts and engorgement (reference outcome group); the “low milk production” cluster (15.4%) was discerned by low milk supply and infant weight concerns; and the “ineffective latch” cluster (33.5%) involved latch problems, sore nipples, and difficulty with positioning. Endocrine (adjusted relative risk ratio [RRR] 2.34, 95% CI 1.10–5.00), cardiovascular (adjusted RRR 2.75, 95% CI 1.01–7.81), and gastrointestinal (adjusted RRR 2.51, 95% CI 1.11–5.69) conditions were associated with the low milk production cluster, and gastrointestinal (adjusted RRR 2.44, 95% CI 1.25–4.77) conditions were additionally associated with the ineffective latch cluster. Conclusion Half of women with chronic conditions experienced clusters of breastfeeding difficulties corresponding either to low milk production or to ineffective latch in the first 6 weeks postpartum. Associations with chronic condition types suggest that connections between lactation physiology and disease pathophysiology should be considered when providing breastfeeding support.

A co-designed evaluation study to identify Breastfeeding Knowledge of General Practitioners’ and Practice Nurses’

“…The aim of this pilot study was to establish the breastfeeding KAPs of GPs and GPNs in one CHO in Ireland. It is recognised that breastfeeding and lactation challenges can develop in the post-natal period and support from healthcare professionals is imperative to achieve positive breastfeeding outcomes ( Brown, 2017 ; Feldman Winter et al ., 2020 ; Buckland et al ., 2022 ; Scime et al ., 2023 ).…”

Ingurgitación mamaria desde la fisioterapia a través de agentes físicos y técnicas manuales: una revisión sistemática con meta-análisis

“…Bogotá, Colombia, vol. 22(2): 1-12, mayo-agosto de 2024 y p = 0.1417, respectivamente) (23,24). Los resultados con los estimadores del tamaño del efecto (d de Cohen) se presentan en la figura 4.…”

“…La ingurgitación mamaria, también llamada congestión mamaria, se considera una edematización y distensión de las mamas, en los primeros días de la lactancia, por dilatación vascular (18)(19)(20)(21)(22), la cual comprime los conductos circundantes y, posteriormente, genera presión vascular y linfática (23). A su vez, la madre puede presentar una producción excesiva de leche en relación con el consumo necesario del bebé.…”

“…Todas las técnicas descritas proporcionan alivio frente a este síntoma; sin embargo, se observó que el alivio podría ser más rápido o un poco más tardío. Así, los estudios donde se incluyó el masaje terapéutico o el dlm refirieron que, además de tener un efecto analgésico y relajante para la madre, mejora la circulación sanguínea y estimula los conductos de las glándulas mamarias, al eliminar la inflamación y el dolor(18)(19)(20)(21)(22)(23)(24)(25). Además, se observó en el estudioIngurgitaciónEn su estudio, Habibu y Hanif (54) concluyeron que el uso de ultrasonido no térmico es eficaz para aliviar la congestión mamaria; entre tanto, Doǧan et al(56) indicaron que se podría aplicar kt para aliviar el dolor de la congestión mamaria en aquellas mujeres que no pueden acudir al hospital de manera frecuente, teniendo en cuenta que el kt ayuda a reducir los espasmos musculares, la sensibilidad del tejido conectivo y a mejorar el flujo linfático.…”