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Peer-reviewedCC BY 4.0Frontiers in Public Health

Factors associated with breastfeeding difficulties in the early postpartum period in China: a cross-sectional study

  • Fangfang Lei1,2
  • Shurong Zhou1,2
  • Yuanqiong Liu1,2
  • Jie Xiang1,2
  • Na Li1,2
  • Yi Liu1,2
  1. 1Department of Obstetric Nursing, West China Second University Hospital, Sichuan University
  2. 2Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University
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Abstract

Objective: Within the unique clinical context of China, characterized by high cesarean section rates and specific postpartum practices, this study aims to investigate the prevalence and characteristics of breastfeeding difficulties in the early postpartum period (within 96 h postpartum) and identify associated factors, informing early clinical screening and targeted interventions.

Methods: This cross-sectional study included 460 postpartum women recruited via convenience sampling from the obstetrics department of a tertiary specialized hospital in Chengdu between July 2023 and November 2024. All assessments were conducted between 24 and 96 h postpartum. Breastfeeding difficulty was operationally defined as the clinical presence of perceived insufficient milk, nipple/breast-related problems, or neonatal factors impeding effective feeding. Data were collected using a sociodemographic questionnaire, the Structured Clinical Breastfeeding Assessment Checklist, the LATCH scoring system, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Edinburgh Postnatal Depression Scale (EPDS). Multivariate binary logistic regression was used to identify independently associated factors.

Results: The prevalence of breastfeeding difficulties was 38.5% (177/460). The primary clinical manifestations were perceived insufficient milk supply (63.8%) and nipple-related problems (11.3%). Multivariate analysis demonstrated that infrequent breastfeeding (< 6 times/day; OR = 3.434), gestational diabetes mellitus (OR = 1.819), elevated pre-pregnancy BMI (24.0–27.9 kg/m ² : OR = 2.484), and elevated postpartum depressive symptoms (OR = 3.365) were independently associated with higher odds of breastfeeding difficulties (all P < 0.05). Conversely, strong family support (OR= 0.911) and higher LATCH scores (OR = 0.646) showed a significant inverse association (all P < 0.05).

Conclusion: Breastfeeding difficulties are common during the early postpartum period and are associated with a combination of maternal physiological conditions, feeding skills, and psychosocial factors. Elevated BMI, gestational diabetes, infrequent early sucking, and elevated postpartum depressive symptoms are key independently associated factors, whereas strong family support and good latching skills show a significant inverse association. Clinical support should prioritize early screening for high-risk women, integrating physical, skill-based, psychological, and familial support to overcome early lactation barriers.

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Cite

BibTeXRIS
BibTeX
@article{lei2026factors,
  title = {{Factors associated with breastfeeding difficulties in the early postpartum period in China: a cross-sectional study}},
  author = {Fangfang Lei and Shurong Zhou and Yuanqiong Liu and Jie Xiang and Na Li and Yi Liu},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1923736},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1923736/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Factors associated with breastfeeding difficulties in the early postpartum period in China: a cross-sectional study
AU  - Fangfang Lei
AU  - Shurong Zhou
AU  - Yuanqiong Liu
AU  - Jie Xiang
AU  - Na Li
AU  - Yi Liu
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1923736
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1923736/full
AB  - Objective: Within the unique clinical context of China, characterized by high cesarean section rates and specific postpartum practices, this study aims to investigate the prevalence and characteristics of breastfeeding difficulties in the early postpartum period (within 96 h postpartum) and identify associated factors, informing early clinical screening and targeted interventions.  Methods: This cross-sectional study included 460 postpartum women recruited via convenience sampling from the obstetrics department of a tertiary specialized hospital in Chengdu between July 2023 and November 2024. All assessments were conducted between 24 and 96 h postpartum. Breastfeeding difficulty was operationally defined as the clinical presence of perceived insufficient milk, nipple/breast-related problems, or neonatal factors impeding effective feeding. Data were collected using a sociodemographic questionnaire, the Structured Clinical Breastfeeding Assessment Checklist, the LATCH scoring system, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Edinburgh Postnatal Depression Scale (EPDS). Multivariate binary logistic regression was used to identify independently associated factors.  Results: The prevalence of breastfeeding difficulties was 38.5% (177/460). The primary clinical manifestations were perceived insufficient milk supply (63.8%) and nipple-related problems (11.3%). Multivariate analysis demonstrated that infrequent breastfeeding (< 6 times/day; OR = 3.434), gestational diabetes mellitus (OR = 1.819), elevated pre-pregnancy BMI (24.0–27.9 kg/m ² : OR = 2.484), and elevated postpartum depressive symptoms (OR = 3.365) were independently associated with higher odds of breastfeeding difficulties (all P < 0.05). Conversely, strong family support (OR= 0.911) and higher LATCH scores (OR = 0.646) showed a significant inverse association (all P < 0.05).  Conclusion: Breastfeeding difficulties are common during the early postpartum period and are associated with a combination of maternal physiological conditions, feeding skills, and psychosocial factors. Elevated BMI, gestational diabetes, infrequent early sucking, and elevated postpartum depressive symptoms are key independently associated factors, whereas strong family support and good latching skills show a significant inverse association. Clinical support should prioritize early screening for high-risk women, integrating physical, skill-based, psychological, and familial support to overcome early lactation barriers.
SN  - 2296-2565
ER  -