Anemia and Insufficient Milk in First-Time Mothers

Abstract Objective: To test whether perception of insufficient milk (PIM) supply in the breast-feeding relationship of one child predicts how long mothers breast-feed subsequent children, and whether this association differs for first-time mothers v. mothers with previous children. Design: Secondary analysis of Infant Feeding Practices Study II (ordinary least squares regression) and Year 6 follow-up. Setting: Mailed, self-report survey of US mother–infant dyads, 2005–2012. Participants: Women pregnant with a singleton were recruited from a consumer opinion panel. Exclusion criteria included: mother age <18; infant born <5 lbs, born before 35 weeks or with extended NICU stay, and mother or infant diagnosed with condition that impacts feeding. A subsample with PIM data (n 1460) was analysed. Results: We found that women who weaned because of PIM with the index child stopped breast-feeding 5·7 weeks earlier than those who weaned due to other reasons (4·9 weeks earlier for multiparas, P < 0·001; 7·1 weeks earlier for primiparas, P < 0·001). Using Year 6 follow-up data (n 350), we found subsequent child 1 weaned 9·2 weeks earlier if the mother experiences PIM as a multipara (P = 0·020) and 10·6 weeks earlier if the mother experiences PIM as a primipara (P = 0·019). For subsequent child 2 (n 78), the magnitude of association was even larger, although insignificant due to low power. Conclusions: These findings indicate that PIM may carry forward in the reproductive life course, especially for first-time mothers. Perceptions of breast milk insufficiency and contributors to actual inadequate milk supply with the first child should be targeted, rather than intervening later in the reproductive life course.

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Striving for sufficient milk to have a healthy late preterm baby: a grounded theory study

10.21203/rs.3.rs-342392/v1 ◽

2021 ◽

Author(s):

Rungtawan Choijorhor ◽

Kannika Kantaruksa ◽

Jutamas Chotibang ◽

Nonglak Chaloumsuk

Keyword(s):

Preterm Infants ◽

Exclusive Breastfeeding ◽

Late Preterm ◽

Milk Supply ◽

Healthy Baby ◽

Late Preterm Infants ◽

Core Category ◽

First Time Mothers ◽

Insufficient Milk ◽

First Time

Abstract Background Late preterm infants are at risk for more health problems than full-term infants. They require good nutrition for growth, and breast milk contains valuable nutrients as the valuable golden standard for them. Currently, the population of late preterm infants is increasing as exclusive breastfeeding rates decrease. Hence, this study explored exclusive breastfeeding experiences among Thai first-time mothers of late preterm infants. Methods Participants were recruited from the family planning unit of a university hospital in Northern Thailand. A grounded theory study design was used, drawing upon an interview guideline with seventeen first-time mothers who exclusively breastfed their late preterm infants for the first six weeks of life. Results “Striving for sufficient milk to have a healthy baby” emerged as the core category. It was defined as a process in which mothers of late preterm infants had to exert great effort toward achieving sufficient milk for their infants. The following three phases supported the core category: preparing for breastfeeding, overcoming the problem of insufficient milk supply, and managing to continue breastfeeding. Conclusion Perceived insufficient milk supply in first-time mothers is a threat to achieving exclusive breastfeeding for their late preterm infants, but the will to have a healthy baby makes it happen. Nurse-midwives could apply the management process of exclusive breastfeeding as a guideline in providing support for these mothers throughout the chain of antenatal, intrapartum, and postpartum care. Trial registration: Permission to conduct the study was obtained from the Institutional Review Board Committee, Faculty of Nursing and the Faculty of Medicine, Chiang Mai University, # No. 2561-EXP065 and No. 2561–05865.

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The Development and Evaluation of a Text Message Program to Prevent Perceived Insufficient Milk Among First-Time Mothers: Retrospective Analysis of a Randomized Controlled Trial (Preprint)

10.2196/preprints.17328 ◽

2019 ◽

Author(s):

Jill R Demirci ◽

Brian Suffoletto ◽

Jack Doman ◽

Melissa Glasser ◽

Judy C Chang ◽

...

Keyword(s):

Text Messaging ◽

Text Message ◽

Text Messages ◽

Breastfeeding Support ◽

Lactation Consultant ◽

First Time Mothers ◽

Perceived Insufficient Milk ◽

Insufficient Milk ◽

First Time ◽

Sms Text Messaging

BACKGROUND Several recent trials have examined the feasibility and efficacy of automated SMS <i>text messaging</i> to provide remote breastfeeding support to mothers, but these texting systems vary in terms of design features and outcomes examined. OBJECTIVE This study examined user engagement with and feedback on a theory-grounded SMS text messaging intervention intended to prevent perceived insufficient milk (PIM)—the single, leading modifiable cause of unintended breastfeeding reduction and cessation. METHODS We recruited 250 nulliparous individuals intending to breastfeed between 13 and 25 weeks of pregnancy in southwestern Pennsylvania. Participants were randomly assigned with equal allocation to either an SMS intervention to prevent PIM and unintended breastfeeding reduction or cessation (MILK, a Mobile, semiautomated text message–based Intervention to prevent perceived Low or insufficient milK supply; n=126) or a control group receiving general perinatal SMS text messaging–based support via the national, free Text4Baby system (n=124). Participants in both groups received SMS text messages 3 to 7 times per week from 25 weeks of pregnancy to 8 weeks postpartum. The MILK intervention incorporated several automated interactivity and personalization features (eg, keyword texting for more detailed information on topics and branched response logic) as well as an option to receive one-on-one assistance from an on-call study lactation consultant. We examined participant interactions with the MILK system, including response rates to SMS text messaging queries. We also sought participant feedback on MILK content, delivery preferences, and overall satisfaction with the system via interviews and a remote survey at 8 weeks postpartum. RESULTS Participants randomized to MILK (87/124, 70.2% white and 84/124, 67.7% college educated) reported that MILK texts increased their breastfeeding confidence and helped them persevere through breastfeeding problems. Of 124 participants, 9 (7.3%) elected to stop MILK messages, and 3 (2.4%) opted to reduce message frequency during the course of the study. There were 46 texts through the MILK system for individualized assistance from the study lactation consultant (25/46, 54% on weekends or after-hours). The most commonly texted keywords for more detailed information occurred during weeks 4 to 6 postpartum and addressed milk volume intake and breastfeeding and sleep patterns. MILK participants stated a preference for anticipatory guidance on potential breastfeeding issues and less content addressing the benefits of breastfeeding. Suggested improvements included extending messaging past 8 weeks, providing access to messaging for partners, and tailoring content based on participants’ pre-existing breastfeeding knowledge and unique breastfeeding trajectory. CONCLUSIONS Prenatal and postpartum evidence–based breastfeeding support delivered via semiautomated SMS text messaging is a feasible and an acceptable intervention for first-time mothers. To optimize engagement with digital breastfeeding interventions, enhanced customization features should be considered. CLINICALTRIAL ClinicalTrials.gov NCT02724969; https://clinicaltrials.gov/ct2/show/NCT02724969

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The Development and Evaluation of a Text Message Program to Prevent Perceived Insufficient Milk Among First-Time Mothers: Retrospective Analysis of a Randomized Controlled Trial

JMIR mhealth and uhealth ◽

10.2196/17328 ◽

2020 ◽

Vol 8 (4) ◽

pp. e17328 ◽

Cited By ~ 1

Author(s):

Jill R Demirci ◽

Brian Suffoletto ◽

Jack Doman ◽

Melissa Glasser ◽

Judy C Chang ◽

...

Keyword(s):

Text Messaging ◽

Text Message ◽

Text Messages ◽

Breastfeeding Support ◽

Lactation Consultant ◽

First Time Mothers ◽

Perceived Insufficient Milk ◽

Insufficient Milk ◽

First Time ◽

Sms Text Messaging

Background Several recent trials have examined the feasibility and efficacy of automated SMS text messaging to provide remote breastfeeding support to mothers, but these texting systems vary in terms of design features and outcomes examined. Objective This study examined user engagement with and feedback on a theory-grounded SMS text messaging intervention intended to prevent perceived insufficient milk (PIM)—the single, leading modifiable cause of unintended breastfeeding reduction and cessation. Methods We recruited 250 nulliparous individuals intending to breastfeed between 13 and 25 weeks of pregnancy in southwestern Pennsylvania. Participants were randomly assigned with equal allocation to either an SMS intervention to prevent PIM and unintended breastfeeding reduction or cessation (MILK, a Mobile, semiautomated text message–based Intervention to prevent perceived Low or insufficient milK supply; n=126) or a control group receiving general perinatal SMS text messaging–based support via the national, free Text4Baby system (n=124). Participants in both groups received SMS text messages 3 to 7 times per week from 25 weeks of pregnancy to 8 weeks postpartum. The MILK intervention incorporated several automated interactivity and personalization features (eg, keyword texting for more detailed information on topics and branched response logic) as well as an option to receive one-on-one assistance from an on-call study lactation consultant. We examined participant interactions with the MILK system, including response rates to SMS text messaging queries. We also sought participant feedback on MILK content, delivery preferences, and overall satisfaction with the system via interviews and a remote survey at 8 weeks postpartum. Results Participants randomized to MILK (87/124, 70.2% white and 84/124, 67.7% college educated) reported that MILK texts increased their breastfeeding confidence and helped them persevere through breastfeeding problems. Of 124 participants, 9 (7.3%) elected to stop MILK messages, and 3 (2.4%) opted to reduce message frequency during the course of the study. There were 46 texts through the MILK system for individualized assistance from the study lactation consultant (25/46, 54% on weekends or after-hours). The most commonly texted keywords for more detailed information occurred during weeks 4 to 6 postpartum and addressed milk volume intake and breastfeeding and sleep patterns. MILK participants stated a preference for anticipatory guidance on potential breastfeeding issues and less content addressing the benefits of breastfeeding. Suggested improvements included extending messaging past 8 weeks, providing access to messaging for partners, and tailoring content based on participants’ pre-existing breastfeeding knowledge and unique breastfeeding trajectory. Conclusions Prenatal and postpartum evidence–based breastfeeding support delivered via semiautomated SMS text messaging is a feasible and an acceptable intervention for first-time mothers. To optimize engagement with digital breastfeeding interventions, enhanced customization features should be considered. Trial Registration ClinicalTrials.gov NCT02724969; https://clinicaltrials.gov/ct2/show/NCT02724969

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