Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Data Collection
2.3. Assessment of Breastfeeding Variables
2.4. Statistical Analyses
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Acknowledgments
Author Contributions
Conflicts of Interest
References
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All Participants (n = 500) | Direct Breastfeeding (n = 217, 43.4%) | Mixed Feeding (Direct and Expressed) (n = 200, 40.0%) | Expressed Breast Milk Only (n = 83, 16.6%) | p | |
---|---|---|---|---|---|
Maternal Age (years), Mean ± SD | 31.7 ± 4.6 | 31.9 ± 5.0 | 31.6 ± 4.3 | 31.6 ± 4.2 | 0.657 |
Pre-pregnancy BMI (kg/m2) | 0.432 | ||||
<18.5 | 62 | 21 (33.9) | 30 (48.4) | 11 (17.7) | |
18.5–<23 | 273 | 114 (41.8) | 113 (41.4) | 46 (16.8) | |
23–<27.5 | 122 | 59 (48.4) | 43 (35.2) | 20 (16.4) | |
≥27.5 | 43 | 23 (53.5) | 14 (32.6) | 6 (14.0) | |
Ethnicity | <0.001 | ||||
Chinese | 322 | 102 (31.7) | 150 (46.6) | 70 (21.7) | |
Malay | 90 | 57 (63.3) | 28 (31.1) | 5 (5.6) | |
Indian | 88 | 58 (65.9) | 22 (25.0) | 8 (9.1) | |
Maternal Education | <0.001 | ||||
No education/Primary/Secondary | 82 | 57 (69.5) | 18 (22.0) | 7 (8.5) | |
Technical College/Pre-university | 152 | 70 (46.1) | 60 (39.5) | 22 (14.5) | |
University | 266 | 90 (33.8) | 122 (45.9) | 54 (20.3) | |
Parity | <0.001 | ||||
Primipara | 230 | 76 (33.0) | 100 (43.5) | 54 (23.5) | |
Multipara | 270 | 141 (52.2) | 100 (37.0) | 29 (10.7) | |
Gestational Age (weeks), Mean ± SD | 39.0 ± 1.0 | 39.0 ± 1.0 | 38.9 ± 1.0 | 39.1 ± 0.9 | 0.269 |
Child’s Birth Weight (g), Mean ± SD | 3167.3 ± 384.3 | 3135.5 ± 361.9 | 3194.2 ± 401.6 | 3185.9 ± 397.0 | 0.265 |
Child’s Birth Weight Percentile | 0.605 | ||||
SGA (<10%) | 55 | 28 (50.9) | 17 (30.9) | 10 (18.2) | |
AGA (10–90%) | 365 | 158 (43.3) | 148 (40.5) | 59 (16.2) | |
LGA (>90%) | 80 | 31 (38.8) | 35 (43.8) | 14 (17.5) | |
Child’s sex | 0.022 | ||||
Male | 264 | 101 (38.3) | 120 (45.5) | 43 (16.3) | |
Female | 236 | 116 (49.2) | 80 (33.9) | 40 (16.9) | |
Delivery Mode | 0.966 | ||||
Vaginal | 355 | 155 (43.7) | 142 (40.0) | 58 (16.3) | |
Caesarean Section | 145 | 62 (42.8) | 58 (40.0) | 25 (17.2) | |
Working during 1st Trimester Pregnancy | <0.001 | ||||
No | 130 | 89 (68.5) | 29 (22.3) | 12 (9.2) | |
Yes | 370 | 128 (34.6) | 171 (46.2) | 71 (19.2) | |
Planned to Breastfeed | 0.863 | ||||
No | 6 | 2 (33.3) | 3 (50.0) | 1 (16.7) | |
Yes | 494 | 215 (43.5) | 197 (39.9) | 82 (16.6) | |
Experienced Pain When Breastfeeding 3 | 0.537 | ||||
No | 184 | 84 (45.7) | 74 (40.2) | 26 (14.1) | |
Yes | 296 | 126 (42.6) | 117 (39.5) | 53 (17.9) | |
Mother‘s Perceived Milk Yield 2,3 | <0.001 | ||||
More than Enough | 132 | 49 (37.1) | 72 (54.5) | 11 (8.3) | |
Just Enough | 194 | 92 (47.4) | 78 (40.2) | 24 (12.4) | |
Not Enough | 153 | 68 (44.4) | 43 (28.1) | 42 (27.5) | |
Breastfeeding Schedule 2,3 | 0.001 | ||||
On Demand | 261 | 120 (46.0) | 112 (42.9) | 29 (11.1) | |
Regularly 2–3 Hourly | 164 | 59 (36.0) | 68 (41.5) | 37 (22.6) | |
Regularly 4 Hourly, or Irregularly | 52 | 30 (57.7) | 12 (23.1) | 10 (19.2) | |
Breastfed at Night 2,3 | <0.001 | ||||
No | 73 | 17 (23.3) | 21 (28.8) | 35 (47.9) | |
Yes | 409 | 193 (47.2) | 172 (42.1) | 44 (10.8) | |
Duration of Any Breastfeeding, Mean ± SD | 9.2 ± 4.4 | 9.5 ± 4.7 | 9.7 ± 4.2 | 7.1 ± 3.6 | <0.001 |
Duration of Full Breastfeeding, Mean ± SD | 2.3 ± 2.1 | 2.3 ± 2.0 | 2.5 ± 2.2 | 1.6 ± 1.6 | 0.001 |
n | Unadjusted OR (95% CI) | Adjusted 1 OR (95% CI) | |
---|---|---|---|
Ethnicity | |||
Chinese | 322 | 3.97 (2.44, 6.43) | 3.41 (1.97, 5.91) |
Malay | 90 | 1.05 (0.57, 1.92) | 1.08 (0.54, 2.19) |
Indian | 88 | Reference | Reference |
Maternal Education | |||
No Education/Primary/Secondary | 82 | Reference | Reference |
Technical College/Pre-university | 152 | 2.58 (1.49, 4.49) | 1.39 (0.76, 2.54) |
University | 266 | 4.17 (2.48, 6.99) | 2.22 (1.22, 4.04) |
Parity | |||
Primipara | 230 | 2.30 (1.64, 3.23) | 1.54 (1.04, 2.26) |
Multipara | 270 | Reference | Reference |
Working during 1st Trimester Pregnancy | |||
No | 130 | Reference | Reference |
Yes | 370 | 3.79 (2.50, 5.74) | 2.53 (1.60, 4.02) |
Terminating any Breastfeeding | Terminating Full Breastfeeding | ||||
---|---|---|---|---|---|
Unadjusted | Adjusted 1 | Unadjusted | Adjusted 1 | ||
n | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
All mothers Breastfeeding at 3 Months Post-delivery | |||||
Direct Breastfeeding | 217 | Reference | Reference | - | - |
Mixed Feeding | 200 | 1.15 (0.91, 1.46) | 1.17 (0.90, 1.52) | - | - |
Expressed Breast Milk Only | 83 | 2.17 (1.62, 2.89) | 2.20 (1.61, 3.02) | - | - |
Mothers Fully Breastfeeding at 3 Months Post-delivery | |||||
Direct Breastfeeding | 72 | Reference | Reference | Reference | Reference |
Mixed Feeding | 76 | 1.27 (0.82, 1.97) | 1.28 (0.75, 2.17) | 0.92 (0.66, 1.28) | 0.90 (0.62, 1.30) |
Expressed Breast Milk Only | 11 | 1.77 (0.82, 3.81) | 2.39 (1.05, 5.41) | 0.94 (0.50, 1.78) | 0.93 (0.48, 1.79) |
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Pang, W.W.; Bernard, J.Y.; Thavamani, G.; Chan, Y.H.; Fok, D.; Soh, S.-E.; Chua, M.C.; Lim, S.B.; Shek, L.P.; Yap, F.; et al. Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding. Nutrients 2017, 9, 547. https://doi.org/10.3390/nu9060547
Pang WW, Bernard JY, Thavamani G, Chan YH, Fok D, Soh S-E, Chua MC, Lim SB, Shek LP, Yap F, et al. Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding. Nutrients. 2017; 9(6):547. https://doi.org/10.3390/nu9060547
Chicago/Turabian StylePang, Wei Wei, Jonathan Y. Bernard, Geetha Thavamani, Yiong Huak Chan, Doris Fok, Shu-E Soh, Mei Chien Chua, Sok Bee Lim, Lynette P. Shek, Fabian Yap, and et al. 2017. "Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding" Nutrients 9, no. 6: 547. https://doi.org/10.3390/nu9060547