1
|
Scime NV, Metcalfe A, Nettel-Aguirre A, Nerenberg K, Seow CH, Tough SC, Chaput KH. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth 2023; 23:90. [PMID: 36732799 PMCID: PMC9893695 DOI: 10.1186/s12884-023-05407-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
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.
Collapse
Affiliation(s)
- Natalie V. Scime
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada
| | - Amy Metcalfe
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Alberto Nettel-Aguirre
- grid.1007.60000 0004 0486 528XCentre For Health and Social Analytics, School of Mathematics and Statistics, National Institute for Applied Statistical Research, University of Wollongong, Wollongong, NSW Australia ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Kara Nerenberg
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Division of General Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Cynthia H. Seow
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Division of Gastroenterology & Hepatology, Department of Medicine, University of Calgary, Calgary, AB Canada
| | - Suzanne C. Tough
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Pediatrics, University of Calgary, Calgary, AB Canada
| | - Kathleen H. Chaput
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB Canada
| |
Collapse
|