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Breastfeeding Problems During First Three Postnatal Days

Monday, October 22, 2012
Room 346-347 (Morial Convention Center)
Josin Raju, MSc1, Manju Vatsa, PhD1 and Ramesh K. Agarwal, MD, DM, Neonatolgy2, (1)College of Nursing, All India Institute of Medical Sciences, New Delhi, India, (2)Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India

Purpose:   We surveyed late preterm and term mother-newborn dyads (n=380) in a tertiary care hospital to determine the epidemiology of breastfeeding problems during initial 72 hours.

Methods: The subjects were enrolled within 12 hours of delivery and assessed 12 hourly for perception of and documented breastfeeding problems using validated open ended questionnaire and checklist respectively.


A total of 220 (57.9%) mothers delivered vaginally, and 228 (60%) had no previous experience of breastfeeding. Nearly all mother-infant dyads had one or more breastfeeding related problems. The major self reported problems included insufficiency of milk (341, 89.7%), difficulty in latching (145, 38.2%) and breast related problems (112, 29.5%). The major documented problems included poor attachment (378, 99.5%), poor positioning (378, 99.5%), breast engorgement (76, 20%) and poor sucking (65, 17.5%).

A significant proportion of mother-infant dyads continued to have breastfeeding problems at 72 hours after delivery. The common problems were poor positioning (121, 31.8%), poor attachment (121, 31.8%) and breast engorgement (71, 18.7%).

Caesarean delivery was found to be a major predictor of self reported breastfeeding problems.


There is a huge burden of breastfeeding problems in mothers delivering at gestation of 34 weeks or more. There is a need to examine the impact of breastfeeding problems and the interventions directed to them on breast feeding outcomes. These findings have a major policy implication for planning postnatal care of mothers and babies.