Published: 2020-09-21

Profile and pattern of infants with mothers having lactation failure

Arti Dhingra, Sonia Bhatt, Rajesh Kashyap


Background: Breastfeeding mothers face various kinds of problems to breastfeeding. Literature on the frequency and outcome of perceived breast milk insufficiency in mothers of hospitalized neonates in India is patchy and scanty.

Methods:  Neonates weighing 1000 grams or more, and their mothers willing to breastfeed formed the study population. Relevant history was taken and clinical examination was performed along with anthropometry of the baby at the time of enrolment in the study. Mothers of neonates were also interviewed. Breast milk was also analyzed for sodium level by ion selective electrophoresis. Weight, head circumference and height were measured at each visit.

Results: Of total 285 mothers, 188 mothers (65.9%) said that their milk formation was not sufficient and remaining 97 mothers said that their milk formation was sufficient to fulfil the needs of newborn. Breast milk sodium level was >16 mmol/L in 142 (75.5%) mothers in the crisis group as compared to 21 (21.6%) in the non crisis group. Babies in the crisis group weighed significantly less at admission as well as discharge. The proportion of sick babies, use of bottles/pacifiers and pre lacteal feeds was significantly higher in the crisis group. The velocity of growth of neonates after discharge in both the groups was comparable.

Conclusions: Lactation failure was more common among those mothers who were involved in delayed initiation of breastfeeding. Structured counselling sessions with reinforcement on lactation support were proved to be useful to mitigate the situation.


Breastfeeding, Counselling, Infants, Lactation failure, Mothers

Full Text:



Bloom G, Goldbloom RB, Robinson SC, Stevens FE. Factors affecting the continuance of breast feeding. Acta Paediatr Scand. 1982;Supple 300:9-14.

Greiner T, Van Estrick P, Latham MC. The insufficient milk syndrome: An alternative explanation. Med Anthropol. 1981;5:233-47.

Neifert MR. Prevention of breastfeeding tragedies. Pediatr Clin N Am. 2001;48:273.

Mogan J. A study of mother’s breastfeeding concerns. Birth. 1986;13:104-8.

Sjolin S, Hofvander Y, Hillervik C. Factors related to early termination of breastfeeding. A retrospective study in Sweden. Acta Pediatr Scand. 1977;66:505-11.

Mathur NB, Seth A, Mishra TK. Physical growth and biochemical indicators of Protein adequacy in exclusively breastfed neonates weighing <1500 grams. J Trop Pediatr. 2000;46:288-92.

World Health Organization CDD Programme. Breastfeeding Counselling: A training course, 1993. Available at: adolescent/documents/pdfs/bc_trainers_guide.pdf. Accessed on 17 August 2020.

Jones J, Steketee RW, Black RE, Bhutta ZA, Morris SS. How many child deaths can we prevent this year. Lancet. 2003;362:65-71.

Mathur GP, Chitranshi S, Mathur S, Singh SB, Bhalla M. Lactation Failure. Indian J Pediatr. 1992;29(12):1541-4.

Auerbach KG, Avery JL. Relactation: A study of 366 cases. Pediatrics. 1980;65:236-42.

Joshi JV, Bhandarkar SD, Chadha M, Balaiah D, Shah R. Menstrual irregularities and lactation failure may precede thyroid dysfunction or goitre. J Post grad Med. 1993;39:137-41.

Mathur NB, Dhingra D. Perceived breast milk insufficiency in mothers of neonates hospitalized in neonatal intensive care unit. The Indian Journal of Pediatrics. 2009;76(10):1003-6.

Aggarwal A, Arora S, Patwari AK. Factors influencing introduction of supplemental feeds before four months. Indian Pediatr. 1998; 35: 269-73.