An Ecological Momentary Assessment of Primiparous Women's Breastfeeding Behavior and Problems From Birth to 8 Weeks.
Jill R Demirci, Debra L Bogen
PMID 28418803WHAT IT FOUND
First-time mothers reported widespread early breastfeeding problems and formula use.
At week 2, 81% endorsed at least one concern; by eight weeks, 77% had given formula at least once.
Key findings
01Women reported 46 unique breastfeeding problems, with latching, perceived inadequate milk, pain, infant falling asleep while breastfeeding, and infant feeding too much named most often; 81% endorsed at least one concern at week 2.
02By eight weeks, 77% (37/48) had given formula at least once.
03Among the 41 women who completed the study, 9 (22%) stopped breastfeeding, most commonly because of inadequate milk volume (6) or latch problems (2).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was a convenience sample of English-speaking, smartphone-owning first-time mothers who intended exclusive breastfeeding for at least 2 months, so it may not represent other postpartum patients. No formal power calculation was performed, so many relationships could not be examined reliably. App feeding data were missing for many women, and it was often unclear whether missing logs meant no feeds or just not recording them. Formula and expressed milk volumes could not be reliably captured. Women who did not document problems may have had no problem or simply did not record it. The study did not capture how severe or complex each breastfeeding problem was. Loss to follow-up may have hidden women who stopped breastfeeding early, so formula use, problems, and cessation may be undercounted. The sample lacked generalizability to women of color and lower socioeconomic status.
The easy way to misread this
Do not conclude that giving formula in hospital caused lower exclusive breastfeeding at two weeks. This was an observational study of selected first-time mothers, and the analysis did not show why formula was given or separate it from other factors.