Relationship of delayed lactogenesis II to maternal perception of insufficient milk: A longitudinal study

Abstract

Aim: To analyze the relationship of delayed lactogenesis II with maternal perception of insufficient milk. Methods: A prospective, multicenter, longitudinal observational study was conducted. Data were obtained at discharge and between 1 and 5 months postpartum on the perception of insufficient milk and related variables, by means of a self-administered questionnaire, and subsequent postal and online follow-up. Logistic regression analysis was used to develop the explanatory model. Results: A total of 260 puerperal mothers participated. Of these, 31.9% had insufficient milk and 23.6% had delayed lactogenesis II. During postpartum admission, delayed lactogenesis II (OR = 2.26; 95%CI = 1.07–4.79), difficulty in breastfeeding (OR = 1.02; 95%CI = 1.00–1.03), and professional help in breastfeeding (OR = 0.70; 95%CI = 0.50–0.97) were associated with maternal perception of insufficient milk. Conclusions: The occurrence of breastfeeding difficulties during postpartum admission and at discharge, especially when there is delayed lactogenesis II, should be considered risk indicators, suggesting the need for additional support to standardized care. The PIM is a suitable indicator to assess the quality of professional breastfeeding support in improvement interventions.

Objetivo: Analizar la relación del retraso de la lactogénesis II con la percepción materna de leche insuficiente. Método: Se realizó un estudio observacional longitudinal prospectivo, multicéntrico. Se obtuvieron datos al alta y entre 1 y 5 meses postparto sobre la percepción de leche insuficiente y las variables relacionadas, mediante un cuestionario autoadministrado, y posterior seguimiento postal y online. Para el desarrollo del modelo explicativo, se realizó un análisis de Regresión Logística. Resultados: Participaron un total de 260 puérperas. El 31,9% de ellas percibió leche insuficiente y el 23,6% presentó retraso de la lactogénesis II. Durante el ingreso posparto, se relacionó con la percepción materna de leche insuficiente el retraso de la lactogénesis II (OR = 2,26; IC95% = 1,07–4,79), la dificultad para amamantar (OR = 1,02; IC95% = 1,00–1,03), y la ayuda de los profesionales en la lactancia (OR = 0,70; IC95% = 0,50–0,97). Conclusiones: La aparición de dificultades en la lactancia durante el ingreso posparto y al alta, especialmente cuando existe un retraso de la lactogénesis II, deben considerarse indicadores de riesgo, que sugieren la necesidad de un apoyo adicional a los cuidados estandarizados. La PIM es un indicador adecuado para evaluar la calidad del apoyo profesional a la lactancia en intervenciones de mejora.