A study of the factors affecting time to onset of lactogenesis-II after parturition

Background: Lactogenesis or the mode of formation of milk. Lactogenesis-II commences after delivery and is the initiation of plentiful milk secretion. Time to lactogenesis is defined as the number of hours between delivery and the time that the sign of a surge in milk production is first observed. If the onset of lactogenesis occurs 72 h postpartum, it is defined as delayed.

Objective: To identify different socioeconomic, demographic and delivery related factors that affect the time of onset of lactogenesis-II.

Design: Six months prospective observational study.

Participants: A total of 200 subjects were recruited into the study. Pregnant women within age limit of 18e65 years of age were included in the study.

Methods: The data were collected from various sources such as patient’s case reports, treatment charts and also through direct patient interview. The significance of the factors affecting onset of lactogenesis-II were assessed by chi-square test. A p-value less than 0.05 were considered to be statistically significant.

Results: The study showed that factors like type of anesthesia, mode of delivery, body mass index, Apgar score, parity, age, education, number of breastfeeding, infant birth weight, hemoglobin level, pregnancy induced hypertension, gestational diabetes mellitus, hypothyroidism are risk factors for delayed onset of lactogenesis-II.

Conclusion: By anticipating delay in lactogenesis-II, because of above mentioned factors clinicians may be able to support nursing mothers and prevent hasty transitions to formula supplementation due to a misperception of insufficient milk production as opposed to a delay in lactogenesis.