Gestational weight gain is associated with delayed onset of lactogenesis in the TMCHC study: A prospective cohort study

Background & aims: Delayed onset of lactogenesis II (OL) negatively affects breastfeeding and consequently, the health of the newborn. Few studies have examined the association between gestational weight gain (GWG) throughout pregnancy and risk of delayed OL. Methods: We used data from a prospective cohort study in Wuhan of China, which enrolled pregnant women at 8-16 weeks of gestation and followed-up regularly. GWG was assessed by the last available weight measurement (LAWM) during pregnancy and the self-reported pre-pregnancy weight at enrollment. The outcome was delayed OL self-reported after 4 days postpartum. Odds ratios (ORs) and 95% confidence intervals (Os) were derived from multivariate logistic regression. Results: Delayed OL was reported by 18.4% of the 3282 participants. After adjustment for the demographic, clinical and breastfeeding characteristics, compared to the lowest quartile 1 of GWG, ORs (95% CIs) were 1.20 (0.91, 1.57) for quartile 2, 1.47 (1.13, 1.92) for quartile 3, and 1.42 (1.08, 1.86) for quartile 4 (P for trend = 0.006). When GWG was classified by the 2009 Institute of Medicine (IOM) guidelines, compared with women with adequate GWG, the adjusted ORs (95% CIs) were 0.82 (0.61,1.10) for inadequate GWG, and 1.13 (0.93, 1.38) for excessive GWG. Conclusions: Women with higher GWG throughout pregnancy are more likely to suffer from delayed OL in Chinese population. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.