A Study On The Correlation Between Delayed Onset Of Lactogenesis And Breastfeeding Self-Efficacy And Analysis Of The Factors Influencing Them

Objective:Breast milk is the best source of nutrition for infants and children from 0 to 6 months of age,and breastfeeding is beneficial to both the mother and the infant.As an important factor affecting breastfeeding and a normal physiological phenomenon after delivery,lactation initiation is one of the keys to enhance breastfeeding rate and duration of breastfeeding.To provide further clinical support and reference for nursing interventions,this study aims to describe the incidence of Delayed Onset of Lactogenesis(DOL)and Maternal Breastfeeding Self-Efficacy(BSE)in postpartum mothers.The aim of this study was to describe the incidence of Delayed Onset of Lactogenesis(DOL)and Maternal Breastfeeding Self-Efficacy(BSE)in the postpartum period and to investigate the factors influencing Delayed Onset of Lactogenesis and Maternal Breastfeeding Self-Efficacy.Methods:In this study,269 mothers were selected between December 2019 and November 2020,and maternal general demographic information and Maternal Breastfeeding Self-Efficacy scores were obtained through questionnaires,telephone follow-up,and review of electronic medical records;maternal delivery information as well as neonatal information was obtained through the electronic medical record system after delivery;24 hours postpartum,48 hours postpartum,and 72 hours postpartum were asked about Lactation initiation was obtained,and if lactation initiation was not obtained,repeated questioning was done within 72 hours after delivery to understand the situation,and depression assessment was also performed on the mother.Data entry was performed using Excel,and SPSS 25.0 was used for data analysis.Descriptive analyses were performed for general demographic data,with median time to lactation initiation,mean±standard deviation(x±s)for Breastfeeding Self-Efficacy and depression scores,chi-square test for one-way analysis of the effect of Delayed Onset of Lactogenesis,and Spearman correlation analysis for the correlation between time to lactation initiation and postpartum depression.For the multifactor analysis of the effect of Delayed Onset of Lactogenesis,binary logistic regression analysis was used.For the single-factor analysis of Breastfeeding Self-Efficacy,independent samples t-test,ANOVA,Pearson correlation analysis were used;for the multi-factor analysis of Breastfeeding Self-Efficacy,multiple linear regression analysis was used for data analysis.Results:1.In 269 mothers,lactation initiation time was skewed,with the longest time being 96 h and the shortest time being 0 h.Delayed Onset of Lactogenesis occurred in 91 mothers,with an incidence of 33.8%.(1)In the univariate analysis of Delayed Onset of Lactogenesis,age,whether the birth was primiparous,whether the pregnancy was planned,whether the birth was painless,whether the mother was separated from the baby,whether the breastfeeding experience was experienced,and access to breastfeeding knowledge,Whether depressed were statistically significant(P<0.05)and influencing factors for Delayed Onset of Lactogenesis.(2)In Spearman’s correlation analysis,the postpartum depression score was positively correlated with the time to lactation initiation(r=0.439,P<0.05),and women with high postpartum depression scores took longer to initiate lactation.(3)In the multifactorial binary logistic regression analysis of Delayed Onset of Lactogenesis,in which education level(bachelor’s degree or higher),painless delivery,experience with breastfeeding,and access to breastfeeding knowledge(≥5),were protective factors for Delayed Onset of Lactogenesis,with ORs of 0.646,0.368,0.310,and 0.208,respectively;five factors,namely,type of disease(diabetes),mode of delivery(cesarean),first birth,mother-infant separation,and postpartum depression,were protective factors for risk factors for Delayed Onset of Lactogenesis with OR values of 1.343,25.269,2.955,17.533,and 3.513,respectively.2.The mean Breastfeeding Self-Efficacy score of 269 mothers in this study was(47.200±9.750),with a minimum value of 20 and a maximum value of 70.(1)In the univariate analysis of Breastfeeding Self-Efficacy,the number of children,whether it was a first birth,whether the newborn had a NICU experience,mode of delivery,whether it was a painless delivery,whether it was preterm,whether the mother was separated from the baby,whether there was a breastfeeding experience,whether it was exclusive breastfeeding,and duration of each breastfeeding were statistically significant(P<0.05)and were the relevant factors affecting Breastfeeding Self-Efficacy.(2)Spearman correlation analysis showed that postpartum depression score was.negatively correlated with Breastfeeding Self-Efficacy score(r=-0.459,P<0.01),and the higher the postpartum depression score,the lower the Breastfeeding Self-Efficacy score.The results of independent samples t-test showed that there was a statistically significant difference in Breastfeeding Self-Efficacy scores between the depressed group and the non-depressed group(P<0.05),with the depressed group scoring(39.38±6.417)lower than the non-depressed group(49.82±8.997);Pearson correlation analysis showed that lactation initiation time was negatively correlated with breastfeeding.The Pearson correlation analysis showed that lactation initiation time was negatively correlated with Breastfeeding Self-Efficacy(r=-0.673,P<0.01),i.e.,the longer the lactation initiation time,the lower the Breastfeeding Self-Efficacy score;and there was a statistically significant difference between the Delayed Onset of Lactogenesis group and the non-delayed group in Breastfeeding Self-Efficacy score(P<0.05),The maternal Breastfeeding Self-Efficacy score was lower in the delayed initiation group(39.70±5.994)than in the non-lactation group(51.03±8.460).(3)In the multi-factor multiple linear regression analysis of Breastfeeding Self-Efficacy,the number of children,whether it was a delivery,whether the newborn had a NICU experience,mode of delivery,whether analgesia was used,whether it was preterm,whether mother-infant separation,whether breastfeeding experience,whether it was exclusive breastfeeding,duration of each breastfeeding,and postpartum depression scores were entered into the regression equation,and the results showed that whether it was a first birth,whether it was exclusive breastfeeding,whether it was exclusive breastfeeding,and postpartum depression scores were The results showed that whether they were primiparous,whether they were exclusively breastfeeding,whether they were separated from mothers and infants,and postpartum depression scores were the influencing factors of Breastfeeding Self-Efficacy.Conclusion:1.Education level,type of disease,mode of delivery,whether the birth was primiparous,whether the mother was separated from the baby,whether the birth was painless,whether there was breastfeeding experience,access to breastfeeding knowledge,and postpartum depression had an effect on whether DOL was delayed.Education level(bachelor’s degree or above),painless delivery,experience with breastfeeding,and access to breastfeeding knowledge(≥5)were protective factors affecting Delayed Onset of Lactogenesis;disease type(diabetes),delivery method(cesarean section),primiparity,mother-infant separation,and postpartum depression were risk factors affecting Delayed Onset of Lactogenesis.2.The higher the postpartum depression score,the longer the time required for lactation initiation and the higher the risk of Delayed Onset of Lactogenesis.It is important to carry out early prenatal depression screening in the clinic.3.The mean BSE score was(47.20±9.750).The number of children,whether the birth was a first birth,whether the newborn had a NICU experience,mode of delivery,whether analgesia was used,whether the birth was preterm,whether the mother was separated from the baby,whether breastfeeding was experienced,whether breastfeeding was exclusive,and the duration of each breastfeeding,DOL,depression had an effect on Breastfeeding Self-Efficacy.Nursing interventions can be carried out for the above influencing factors regarding different populations to improve Breastfeeding Self-Efficacy.4.Maternal postpartum depression is negatively correlated with breastfeeding self-efficacy.The lower the evaluation score of postpartum depression,the higher the breastfeeding self-efficacy score.5.Postpartum lactation initiation time is negatively correlated with breastfeeding self-efficacy.Women with short lactation initiation time have higher breastfeeding self-efficacy scores,and women with delayed lactation initiation have lower breastfeeding self-efficacy scores.