Doula care, early breastfeeding outcomes, and breastfeeding status at 6 weeks postpartum among low-income primiparae

Laurie A. Nommsen-rivers, Ann M. Mastergeorge, Robin L Hansen, Arlene S. Cullum, Kathryn G. Dewey

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Objective: To examine associations between doula care, early breastfeeding outcomes, and breastfeeding duration. Design: Prospective cohort. Setting: Regional hospital in northern California. Participants: Low-income, full gestation primiparae receiving doula care (n = 44) or standard care (n = 97). Measures: Birth outcomes and newborn feeding data obtained from the hospital record. Follow-up interviews conducted at day 3 to record the timing of onset of lactogenesis and breastfeeding behavior and at 6 weeks to obtain current breastfeeding status. Results: Adjusting for baseline differences, women receiving doula care were significantly more likely to have a short stage II labor, a noninstrumental vaginal delivery, and to experience onset of lactogenesis within 72 hours postpartum (timely onset of lactogenesis). Overall, 68% of women receiving doula care and 54% of women receiving standard care were breastfeeding at 6 weeks. In the subset with a prenatal stressor (n = 63), the doula care group was more than twice as likely to be breastfeeding at 6 weeks (89% vs. standard care, 40%). Breastfeeding at 6 weeks was also significantly associated with timely onset of lactogenesis and maternal report that the infant "sucked well" at day 3. Conclusions: Doula care was associated with improved childbirth outcomes and timely onset of lactogenesis. Both directly and as mediated by timely onset of lactogenesis, doula care was also associated with higher breastfeeding prevalence at 6 weeks.

Original languageEnglish (US)
Pages (from-to)157-173
Number of pages17
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
Volume38
Issue number2
DOIs
StatePublished - 2009

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Doulas
Breast Feeding
Postpartum Period
Parturition
Hospital Records
Mothers
Outcome Assessment (Health Care)
Newborn Infant
Interviews

Keywords

  • Breastfeeding
  • Childbirth
  • Doula
  • Lactogenesis

ASJC Scopus subject areas

  • Maternity and Midwifery
  • Pediatrics
  • Critical Care

Cite this

Doula care, early breastfeeding outcomes, and breastfeeding status at 6 weeks postpartum among low-income primiparae. / Nommsen-rivers, Laurie A.; Mastergeorge, Ann M.; Hansen, Robin L; Cullum, Arlene S.; Dewey, Kathryn G.

In: JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, Vol. 38, No. 2, 2009, p. 157-173.

Research output: Contribution to journalArticle

Nommsen-rivers, Laurie A. ; Mastergeorge, Ann M. ; Hansen, Robin L ; Cullum, Arlene S. ; Dewey, Kathryn G. / Doula care, early breastfeeding outcomes, and breastfeeding status at 6 weeks postpartum among low-income primiparae. In: JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2009 ; Vol. 38, No. 2. pp. 157-173.
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