Lactation failure

Abstract

Seventy five mothers with lactation failure were studied, whose less than 4-month-old babies were admitted to the hospital. Partial lactational failure (94.7%) was noted more often than complete lactational failure (5.3%). Initiation of breastfeeding was delayed for 2 to 5 days usually for traditional reasons (77.3%) and because the mothers felt that the milk output was inadequate (92%). The various causes of lactation failure were determined and the relationship to various factors was analyzed. The commonest cause of lactation failure was insufficient milk or no milk (80%). The age, parity, education, socio-economic status, religion, family structure and urban vs rural status of mother--all had a bearing on the occurrence of lactation failure. An attempt was made to relactate all these mothers. The outcome was successful in 69.3 cases and failed in only 4% cases. In 26.7% cases, we cannot predict the outcome as the mothers hospital stay was very brief with no follow up.

PIP: A total of 75 mothers whose babies under 4 months old were hospitalized with lactation failure were studied. The age of the mothers varied from 16 years to 40 years with a mean of 23.7 years. 50 (66.7%) of the mothers were from the urban areas. 43 (57.3%) of them were primipara and 61 (81.3%) were Hindus. All the mothers given prelacteal feeds comprising water, water with sugar or glucose, milk (goat, cow, or milk powder) to their babies. The commonest cause of lactation failure with insufficient milk or no milk (80%). The age, parity, education, socioeconomic status, religion, family structure, and urban vs. rural residence of mother had a bearing on the occurrence of lactation failure. The initiation of breast feeding was delayed for 2-5 days usually for traditional reasons (77.3%) and because the mothers felt that the milk output was inadequate (92%). Only 4 (5.3%) mothers had complete lactation failure and practiced exclusive top feeding. Of the 71 (94.7%) mothers with partial lactation failure, 41 (54.7%) were giving frequent breast feeds while 30 (40%) were breast feeding occasionally. Relactation was attempted in all cases. Mothers have been motivated to breast feed and were provided adequate rest, nutrition, and psychological support. If lactation was still not established, then metoclopramide was given orally in the 8-hourly dosage of 10 mg for 10 days. If this also failed, nursing supplementer was tried. The relactation attempt was successful in 49 (69.3%) partial and 3 (7.5%) complete lactation failure cases. Relactation failed in 22 (30.7%) mothers with partial lactation failure and 1 (2.5%) mother with complete lactation failure. (26.7%) mothers with partial lactation failure were lost to follow up. Out of 4 cases of complete lactation failure, 1 had severe anemia with hypoproteinemia, the 2nd developed intense dislike of her baby at birth, the 3rd had tuberculosis and was advised not to breast feed, and in the 4th case the mother stopped breast feeding completely because she felt that her milk was unsuitable.