Cases with higher BF frequency during the first four weeks postpartum

The participant BA initiated BF within one hour after birth. She reported that she

breastfed the baby on demand. At two weeks she breastfed the baby 17 time/day, the

longest interval between BF was 4.5 hours/day and the total length of BF

sessions/day was 4.3 hours/day. BF sessions ranged between 5-20 minutes (median

13.5 minutes). From 2-10 weeks the number of BF/day was between 15-21

times/day, the longest interval between BF generally increased from 4.5-6.1

hours/day, the mother said that the baby’s sleeping patterns changed from “awake more during the day time, a little less often at night” to “often sleeping for 5-6 hours”. The total length of BF sessions/day was 5.1 hours at 6 weeks and had reduced to 2.8 hours. The median BF sessions nearly remained around 10 minutes

(range between 2-25 minutes) (Figure 4.12).

At 12 weeks, BA breastfed the baby 16 times/day, the longest interval between BF

was seven hours/day, and the total length of BF sessions/day was 2.2 hours/day, and

median BF sessions in 24 hours was eight minutes and ranged between 2.5-15

minutes. The mother reported that the baby’s feeding and sleeping was normal, “starting sleeping through the night sometimes and maybe a little quicker in feeding”, and also she had a good feeling for feeding the baby. Compared to BF practices at

12 weeks, between 16-24 weeks, the overall numbers of breastfeeds increased

(between 18-22 times/day), while the longest interval between BF remained similar

(between 3.3-3.6 hours/day) as did the total length of BF sessions/day (between 2.5-

3.3 hours/day). The BF sessions tended to be shorter (ranged 1-15.5 minutes,

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wanted to feed every hour till six AM., and breastfed a bit shorter during the day

time”. At 24 weeks, the infant was given CF, and BF was different, the mother said “sleeping were worse than normal― woke more in the night, had more feeds” (Figure 4.12).

From 28-48 weeks, the number of breastfeeds remained stable between 13-14

times/day which was less frequent than before. The total length of BF sessions/day

was 1.5-2.3 hours/day and median BF sessions was five minutes (range 2-15 minutes)

at 40 weeks. There was an unusual case ― 14.3 hours/day of the total length of BF sessions/day and 40 minutes median BF sessions (range 7-75 minutes). The longest

interval between BF remained between 4-4.6 hours/day. At 48 weeks the longest

interval between BF was 13 hours/day (Figure 4.12).

All in all, BA breastfed the baby at least 13 times/day throughout the period of the

first 48 weeks whenever she perceived the baby needed a BF. At 16 weeks she

reported that she felt exhausted especially for the night feeds, but she said she had to

feed the baby, because she did not want to get the baby upset and leave the baby to

cry. During the first 36 weeks, BF sessions ranged 1-25 minutes, and the longest

interval between BF did not tend to increase and fluctuated between 3-7 hours

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A: Respondent BA: Breastfeeding frequency per day during the first 12 months postpartum

B: Respondent BA: Longest interval between breastfeeds per day during the first 12 months postpartum

Introducing CF

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C: Respondent BA: Total length of breastfeeding sessions per day during the first 12 months postpartum

D: Respondent BA: Length of each breastfeeding session per day during the first 12 months postpartum

Figure 4.12. Breastfeeding practices for the respondent BA who has high BF frequency at two weeks. A: breastfeeding frequency; B: longest interval between breastfeeds; C: total length of breastfeeding sessions; D: length of each

breastfeeding session.

Note: Two BF sessions at 40 weeks of 165 and 275minutes (owing to co-sleeping) were omitted.

Introducing CF

78

The respondent BD first breastfed her baby about ten minutes after delivery. She

said she was generally BF to a schedule. She said that during the first half year she

BF roughly every 3-4 hours during the day, and 2-3 times at night when the baby

woke. This pattern then changed to about four hourly breastfed during 24 hours, and

finally at 48 weeks the infant only breastfed scarcely. At two weeks, she breastfed

the baby ten times/day, the longest interval between BF was four hours/day, the total

length of BF sessions/day was 3.8 hours/day and median BF sessions was 25

minutes, ranging from 10-45 minutes. And four and six weeks, the infant was

breastfed from 16-14 times/day with short feeds (median about five minutes, with

total 1.1-2.5 hours/day). The mother reported the infants was “more unsettled than usual in the evening”. The longest interval between BF remained about 5.5 hours/day (Figure 4.13).

From 8-16 weeks, the number of breastfeeds declined from 14-11 times/day, the

longest interval between BF ranged between 5.5-7.1 hours/day, and the total length

of BF sessions/day dropped between 1-1.8 hours/day. The median BF sessions also

remained at 5 minutes and ranged 2-8 minutes, with a relatively wide variation at

eight weeks (1-20 minutes). The mother reported at eight weeks, “bigger stretches at night without needing a feed, went for 6.5 hours during the night”, and “usually wakes once in the night”. At 20 weeks, CF were introduced to the infant, and there was nearly no change in BF frequency (ten times/day), longest interval between BF

(6.4 hours/day), total length of BF sessions/day (0.9 hours/day), and the median BF

session (five minutes), compared to the prior eight weeks (Figure 4.13).

Between 24-28 weeks, BD breastfed the baby 12 times/day, she said “feed more frequently due to mastitis”, while the longest interval between BF (6.5-6.7

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hours/day), total length of BF sessions/day (1.1-1 hours/day), and median BF

sessions (five minutes) remained similar as 20 weeks. From 32-48 weeks, the

number of breastfeeds decreased from 8-4 times/day, the longest interval increased

from 7.4-12.4 hours/day, but total length of BF sessions and the median BF sessions

was hardly changed (Figure 4.13).

Throughout the observed period, the baby was breastfed frequently ― at least eight times/day during the first 36 weeks, and normally had short BF sessions (majority of

feeds less than ten minutes with median five minutes at the majority observations).

The longest interval between BF increased from four hours to above 12 hours from

2-48 weeks (Figure 4.13).

This respondent reported BD breastfed the infant between 3-4 hours during the

daytime, which remained during the period of about more than the first half year.

Night-time breastfeeds were affected by sleeping patterns of the infant. She

mentioned that she and her infant was sick and noisy family environment (due to

friends staying), which may have an influence on BF practices as well. Overall, BD

thought she breastfed successfully and BF was important.

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A: Respondent BD: Breastfeeding frequency per day during the first 12 months postpartum

B: Respondent BD: Longest interval between breastfeeds per day during the first 12 months postpartum

Introducing CF

81

C: Respondent BD: Total length of breastfeeding sessions per day during the first 12 months postpartum

D: Respondent BD: Length of each breastfeeding session per day during the first 12 months postpartum

Figure 4.13. Breastfeeding practices for the respondent BD who has high BF

frequency at four week. A: breastfeeding frequency; B: longest interval between

breastfeeds; C: total length of breastfeeding sessions; D: length of each breastfeeding session.

Introducing CF

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Chapter Five

Discussion