ArticleInternational breastfeeding journal2025
Knowledge, attitude, and practice toward delayed onset of lactogenesis among postpartum women experiencing mother-infant separation: a multi-center cross-sectional study.
Article in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Mechanistic Pathways Underlying Breastfeeding Challenges Following Cesarean Delivery: A Systematic Review.Nutrients · 2026Pooled it
- Development and internal validation of an interpretable machine learning model using first-24-h postpartum nursing variables to predict delayed lactogenesis II after cesarean delivery.Frontiers in medicine · 2026Article
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7 authors.
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Abstract
backgroundDelayed onset of lactogenesis (DOL) is a significant barrier to successful breastfeeding, particularly for women experiencing mother–infant separation due to preterm birth or neonatal complications. This separation disrupts crucial early breastfeeding triggers. Understanding maternal knowledge, attitude, and practice (KAP) toward DOL is essential for improving outcomes. However, few studies have explored this relationship, especially in China where such separation is common. This study aimed to investigate the KAP toward DOL among postpartum women experiencing mother–infant separation and to examine the associations between these dimensions.
methodsThis multicenter cross-sectional survey was conducted in 11 tertiary hospitals in China from June to December 2023. We included 528 mothers over 20 years old who intended to breastfeed and experienced mother–infant separation requiring NICU admission. We assessed KAP toward DOL using a validated, self-designed questionnaire. Data were collected at or beyond 72 h postpartum, allowing participants to reflect on their early lactation experience.
resultsA total of 528 valid questionnaires were analyzed (mean age: 30.08 ± 5.14 years), with 321 individuals (60.8%) suffering from DOL. The mean scores for knowledge, attitude, and practice were 14.02 ± 5.04 (range: 0–26), 15.38 ± 5.02 (range: 6–30), and 27.73 ± 8.98 (range: 9–45), respectively. Multivariate logistic regression showed that a positive attitude (OR 1.37; 95% CI 1.29, 1.45), premature birth (OR 1.79; 95% CI 1.13, 2.83), and mother–infant separation for 1–3 days (OR 2.39; 95% CI 1.31, 4.37) or 4–7 days (OR 2.49; 95% CI 1.36, 4.54) were independently associated with breastfeeding practice. A structural equation model (SEM) confirmed that attitude significantly influenced practice (β = 0.90, P < 0.001).
conclusionsOur findings underscore the importance of fostering positive maternal attitudes through structured lactation support from healthcare providers. Healthcare systems should implement targeted counseling and consider evaluating motivational interviewing as a strategy to enhance breastfeeding practices among mothers with infants in the NICU, thereby improving adherence to recommendations and reducing the incidence of DOL. CLINICAL TRIAL NUMBER: Not applicable.
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