Objective: To evaluate the effect of severe life events at first, second and third trimester, excessive weight gain during pregnancy and caesarean section on the delayed onset of lactation.
Methods: The effect of life stressful event during different gestational age in a total of 2017 parturient women giving birth in hospitals was assessed with reliable questionnaires. Demographic characteristics, history of pregnancy, BMI at early pregnancy and antepartum and the delivery outcomes including gestational age at birth, mode of delivery and the condition of babies were collected by interviewing or from medical charts. Lactation guidance was provided and the data on the onset of lactation were collected in hospitals within 72 hours after parturition. The onset of lactation was defined by the perception of mothers on the fullness of the breast. Univariate and multivariate logistic regression analyses were performed after controlling maternal age, registered permanent residency and educational level.
Results: Delayed onset of lactation occurred in 9.5% of 2017 women and was associated with exposure to severe life events at the first trimester (crude RR = 1.72, 95% CI 0.97 - 3.04, adjusted RR = 1.97, 95% CI 1.09 - 3.55) , increasing of BMI > or = 7.6 during pregnancy (crude RR = 1.93, 95% CI 1.23 - 2.94, adjusted RR = 1.64, 95% CI 1.07 - 2.54) and caesarean section (crude RR = 1.35, 95% CI 1.20 - 1.53, adjusted RR = 1.32, 95% CI 1.17 - 1.49).
Conclusion: Success on early lactation is strongly influenced by potentially modifiable factors, such as exposure to severe life events in the first gestational age, excessive weight gain during pregnancy and caesarean section.