ArticleThe American journal of clinical nutrition2010
Delayed onset of lactogenesis among first-time mothers is related to maternal obesity and factors associated with ineffective breastfeeding.
Article in The American journal of clinical nutrition, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 140 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Metformin to Augment Low Milk Supply in Pre-diabetic Mothers, a Phase I/II Randomized Clinical Trial
Open the trial in the graphEffect of an Immediate-postpartum Support by IBCLC to Women With Obesity, on Breastfeeding Performance: A Randomized Trial.
Who cites it
140 citing papers in PubMed, 5 syntheses or guidelines pooled it, 305 citations in OpenAlex.
- Incidence and factors influencing delayed onset of lactation: a systematic review and meta-analysis.International breastfeeding journal · 2024Pooled it
- Risk factors for self-reported insufficient milk during the first 6 months of life: A systematic review.Maternal & child nutrition · 2022Pooled it
- Breastfeeding experiences and support for women who are overweight or obese: A mixed-methods systematic review.Maternal & child nutrition · 2020Pooled it
- The association between psychological factors and breastfeeding behaviour in women with a body mass index (BMI) ≥30 kg mObesity reviews : an official journal of the International Association for the Study of Obesity · 2018Pooled it
- Breast-feeding and postpartum weight retention: a systematic review and meta-analysis.Public health nutrition · 2015Pooled it
- Does Antenatal Expressing Affect Onset of Lactogenesis for Women With Diabetes? Results From a Randomised Controlled Trial and Cohort Study.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Trial
- Breastfeeding behaviours in women with obesity; associations with weight retention and the serum metabolome: a secondary analysis of UPBEAT.International journal of obesity (2005) · 2024Trial
- Feasibility and Acceptability of Metformin to Augment Low Milk Supply: A Pilot Randomized Controlled Trial.Journal of human lactation : official journal of International Lactation Consultant Association · 2019Trial
- Trial
- Effect of pumping pressure on onset of lactation after caesarean section: A randomized controlled study.Maternal & child nutrition · 2018Trial
- Efficacy of a galactogogue containing silymarin-phosphatidylserine and galega in mothers of preterm infants: a randomized controlled trial.European journal of clinical nutrition · 2016Trial
- Reducing postpartum weight retention and improving breastfeeding outcomes in overweight women: a pilot randomised controlled trial.Nutrients · 2015Trial
- Breastfeeding education and support trial for overweight and obese women: a randomized trial.Pediatrics · 2013Trial
- Insulin sensitivity and mitochondrial homeostasis connect lactation to maternal metabolic health.The Journal of clinical investigation · 2026Article
- Human Milk Sodium Monitoring Across the Continuum of Lactation: From Secretory Activation to Established Lactation.Nutrients · 2026Article
- Prolactin in high-metabolic risk pregnancies: Associations with maternal obesity and metabolic health.Acta obstetricia et gynecologica Scandinavica · 2026Observational
- Modification of a breast pump suction pattern increases milk yield during the first 4 days postpartum.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Article
- Severe Maternal Morbidity and Breastfeeding Among Nulliparous Individuals in the United States.Obstetrics and gynecology · 2026Article
- Mammary gland development and function in maternal obesity and gestational diabetes.Current opinion in physiology · 2026Article
80 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelayed onset of lactogenesis (OL) is most common in primiparas and increases the risk of excess neonatal weight loss, formula supplementation, and early weaning.
objectiveWe examined variables associated with delayed OL among first-time mothers who delivered at term and initiated breastfeeding (n = 431).
designWe conducted in-person interviews during pregnancy and at days 0, 3, and 7 postpartum and extracted obstetric and newborn information from medical records. We defined OL as delayed if it occurred after 72 h and used chi-square analysis to examine its association with potential risk factors across 6 dimensions: 1) prenatal characteristics, 2) maternal anthropometric characteristics, 3) labor and delivery experience, 4) newborn characteristics, 5) maternal postpartum factors, and 6) infant feeding variables. We examined independent associations by using multivariable logistic regression analysis.
resultsMedian OL was 68.9 h postpartum; 44% of mothers experienced delayed OL. We observed significant bivariate associations between delayed OL and variables in all 6 dimensions (P < 0.05). In a multivariate model adjusted for prenatal feeding intentions, independent risk factors for delayed OL were maternal age > or =30 y, body mass index in the overweight or obese range, birth weight >3600 g, absence of nipple discomfort between 0-3 d postpartum, and infant failing to "breastfeed well" > or =2 times in the first 24 h. Postpartum edema was significant in an alternate model excluding body mass index (P < 0.05).
conclusionsThe risk factors for delayed OL are multidimensional. Public health and obstetric and maternity care interventions are needed to address what has become an alarmingly common problem among primiparas.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.