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A Survey on the Factors Related to the Failure of Breast-feeding

Journal of the Korean Pediatric Society 1997;40(10):1336-1346.
Published online October 15, 1997.
A Survey on the Factors Related to the Failure of Breast-feeding
Seung Joo Lee1, Jeong Wan Seo1, Jae Ock Park2, Jae Hoon Shin3, Hae Ran Lee4, Ji Tae Chung5, Hae II Chung6
1The Nutritional Committee of The Korean Pediatric Association, Ewha Medical College
2The Nutritional Committee of The Korean Pediatric Association, Soonchunhyang Medical College
3The Nutritional Committee of The Korean Pediatric Association, Hannyang Medical College
4The Nutritional Committee of The Korean Pediatric Association, Hanlym Medical College
5The Nutritional Committee of The Korean Pediatric Association, Koryo Medical College
6The Nutritional Committee of The Korean Pediatric Association, Seoul Medical College
모유수유 실패요인에 대한 연구
이승주1, 서정완1, 박재옥2, 신재훈3, 이혜란4, 정지태5, 정해일6
1대한소아과학회 영양위원회, 이화의대
2대한소아과학회 영양위원회, 순천향의대
3대한소아과학회 영양위원회, 한양의대
4대한소아과학회 영양위원회, 한림의대
5대한소아과학회 영양위원회, 고려의대
6대한소아과학회 영양위원회, 서울의대
Abstract
Objective : The breast-feeding rate has decreased in Korea despite of the active encouraging effort of breast-feeding for the last 10 years. So we investigated the factors that are related to breast-feeding failure. Method : 1807 specific questionares of mothers who visited the six university hospitals in Seoul from October 1993 to December 1995 were analysed by ANOVA and multiple logistic regression using SAS program.
Results
: 1) Exclusive breast-feeding rate for the first 6 months was 20.0%. The factors of breast feeding success were antenatal plan for breast-feeding, the first successful breastfeeding and breast-feeding in the hospital after delivery(P < 0.01). 2) The duration of breast-feeding was 5.2±4.4 months. It was significantly longer in the first successful breast-feeding(P < 0.01). The earlier the first breast-feeding, the longer the breast-feeding duration(P < 0.01). 3) The breast feeding rate for the first feeding after delivery was significantly higher in normal delivery(46.5%) and the rooming-in(57.4%) than in Cesarean section(37.1%) and the nursery(39.1%)(P < 0.01). 4) The first time of breast-feeding was 64.8±62.8 hours after delivery and was significantly earlier in the local clinic, normal delivery and rooming-in than in the hospital, Cesarian section and the nursery(P < 0.01). The first breast-feeding was successful in 46.9% and was significantly higher in antenatal education(P < 0.01). 5) The reasons for the breast-feeding failure within postnatal one month were the insufficient milk(37.1%), the physician’s recommendation(18.8%), the inverted nipple (12.1%), the baby' s poor suckling power(10.5%) and thin breast-milk(7.0%). The reasons to switch the successful breast-feeding to formula-feeding before 6 months of age were the return to work(25.1%), the convenience of formula-feeding (17.4%), the excellency of formula(10.0%) and maternal conveniency(6.2%). 6) The reasons to consider the breast milk insufficient were too frequent feeding with crying(38.7%) and poor sleeping with irritability(19.0%). The reasons to consider the breast milk thin were the loose stool(51.1%) and watery nature of breast milk(48.9%). The effort to increase the breask milk was present in 68.2%. The most frequent effort was to increase the maternal intake(67.6%) instead of the frequent baby’s suckling (25.6%). 7) Persons who recommended to stop breast feeding were family members 62.7%, pediatricians 25.5%, obstetricians 10.7%, nurses 1.1%. The maternal diseases to stop breast feeding by physician such as mastitis(11.1%), hepatitis B(4.9%) and tuberculosis (2.5%) were relatively appropriate. But the baby’s diseases such as jaundice (29.9%), loose stool(22.2%) and vomiting(2.8%) were inappropriate.
Conclusions
: To increase the breast-feeding rate, we recommend the antenatal plan for breast-feeding, the early breast-feeding as soon as possible and the exclusive breast-feeding in the hospital after delivery. The mothers should make an effort to increase the breast milk by frequent suckling. The physicians should be better prepared to assist the breast-feeding mothers and monitor continuously to resume even after the temporary hold of breast-feeding.
Key Words: Breast-feeding failure, Factors


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