Research Challenges and Considerations in Investigating Rare Exposures Using Breast Hypoplasia as an Example

Kam, Renee L.; Cullinane, Méabh; Amir, Lisa H

doi:10.1177/08903344211037620

Cited by 1 publication

(1 citation statement)

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“…Future research is needed to examine reasons why women report low milk supply as the most common reason for ceasing breastfeeding prematurely. Projects are needed to increase knowledge about all the determinants of insufficient milk production, including breast hypoplasia despite the methodological challenges [ 53 ]. Research comparing the breast anatomy of women with low supply versus women who make a full supply would be useful to assist with determining which characteristics provide the strongest indication for the risk of low milk production.…”

Section: Discussionmentioning

confidence: 99%

Breast hypoplasia markers among women who report insufficient milk production: A retrospective online survey

Kam,

Amir,

Cullinane

et al. 2024

PLoS ONE

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Objectives To estimate the proportions of anatomical breast characteristics suggestive of breast hypoplasia among breastfeeding women self-reporting low milk supply. We also explored breast hypoplasia risk factors. Design Online survey conducted between October 2021 and January 2022. Setting Five low milk supply Facebook groups. Participants 487 women reporting low milk supply with their first child born ≥ 37 weeks gestation within 5 years of participation in this study, and residing in the USA, Australia or the UK. We present data on the primary outcome (‘breast type’) for 399 women. Women were excluded if the dyad was separated for more than 24 hours during the hospital stay, or if the mother reported removing milk less than 6 times per day from each breast on most days before being aware of having insufficient milk production. Primary and secondary outcome measures The proportions of proposed breast hypoplasia markers including atypical breast type, widely spaced breasts, breast asymmetry, stretch marks on the breast and lack of pregnancy breast growth. We also estimated the odds of having breast hypoplasia markers in at-risk groups compared to reference groups, adjusting for covariates. Results Approximately 68% reported at least one atypical breast (270/399; 95% CI: 62.9%, 72.1%). Around 47% reported widely spaced breasts (212/449; 95% CI: 42.7%, 52.7%), 72% a lack of pregnancy breast growth (322/449; 95% CI: 68.3%, 77.4%), and 76% stretch marks on the breast (191/250; 95% CI: 70.7%, 81.3%). Multiple logistic regression analyses identified being overweight during pubertal years as a risk factor for atypical breast type and lack of pregnancy breast growth. Conclusions Participants in low milk supply Facebook groups reported high rates of breast hypoplasia markers. Being overweight during adolescence was a risk factor for breast hypoplasia markers. These findings should be confirmed in well-conducted large cohort studies to determine the strongest combination of hypoplasia markers in predicting low supply.

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Section: Discussionmentioning

confidence: 99%