Exclusive breastfeeding

2 Different studies explored factors influencing the exclusivity of breastfeeding. In California Bramson et al studied the effects of postpartum skin-to-skin contact between mothers and babies and found that the longer the skin-contact episode, the greater the chance that the child was exclusively breastfed at discharge. Bai et al in Indiana studied factors that influenced exclusive breastfeeding for the first 6 months and they found that the vast maternal determination to exclusively breastfeed for a set period was a good predictor for exclusive breastfeeding duration. Their advice thus is to include pregnant women in prenatal pro breastfeeding campaigns. Another factor to challenge exclusive breastfeeding is delayed lactogenisis II (onset of mature milk), beyond the main 3 days, because the urge to supplement with other milk becomes more and more tempting as mom’s own milk does not seem to show up. Many first time mothers will have to wait more than 3 days after birthing before their milk ‘’comes in’’. Besides being a first time mom other factors to delay the onset of mature milk are in the mother being over 30 years of age, BMI over 30, postpartum edema, and the absence of nipple discomfort in the first 3 days, and in the baby being under 3600grams at birth and 2 or more episodes of inaccurate breastfeeding in the first days.
Bramson,  L, Lee JW, Moore E, Montgomery S, Neish C, Bahjri K, Lopez MelcherC:  Effect of Early Skin-to-Skin Mother—Infant Contact During the First 3 Hours Following Birth on Exclusive Breastfeeding During the Maternity Hospital Stay. J Hum Lact  May 2010   vol. 26  no. 2  130-137
Bai Y, Middlestadt SE, Peng C-Y J, Fly AD: Predictors of Continuation of Exclusive Breastfeeding for the First Six Months of Life.J Hum Lact. 26(1):26-34
Nommsen-Rivers LA, Chantry CJ, Peerson JM, Cohen RJ, Dewey KG: Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding.  Am J Clin Nutr (June 23, 2010).