The Influence of Spinal Cord Injury on Breastfeeding Ability and Behavior

Author:

Holmgren Theodor1,Lee Amanda H. X.23ORCID,Hocaloski Shea4,Hamilton Lynsey J.5,Hellsing Iris1,Elliott Stacy678,Hultling Claes1,Krassioukov Andrei V.2348

Affiliation:

1. Neurorehabilitation Section, Division of Neurodegeneration, Spinalis SCI Research Unit, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

2. Experimental Medicine Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

3. International Collaboration on Repair Discoveries, Vancouver, BC, Canada

4. GF Strong Rehabilitation Centre, Vancouver, BC, Canada

5. Midwifery Program, Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

6. BC Centre for Sexual Medicine, Vancouver Coastal Health, Vancouver, BC, Canada

7. Departments of Psychiatry and Urological Sciences, University of British Columbia, Vancouver, BC, Canada

8. Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada

Abstract

Background: Lactation dysfunction following spinal cord injury has been noted in the literature. However, researchers have often grouped together all women of physical disability or do not account for injury level. The extent of lactation dysfunction and influence of spinal cord injury on breastfeeding ability and behavior is not well understood. Research aim: This study aimed to identify major barriers to lactation and breastfeeding related to spinal cord injury, specifically comparing high- and low-level injuries. Methods: A retrospective cross-sectional survey design was used. Two online questionnaires were developed and completed by women ( N = 52) who chose to breastfeed with spinal cord injury, primarily in Canada and Sweden. Results: The first questionnaire was completed by 52 women with spinal cord injury; 38 of the original 52 participants completed the second questionnaire. Of the 52 women, 28 (53.8%) had high-level spinal cord injury (at or above T6) and 24 (46.1%) had low-level injury (below T6). On the second questionnaire, 14 (77.8%) women with high-level injury reported insufficient milk production or ejection. Only 35% of women ( n = 7) with low-level injury reported the same. Autonomic dysreflexia was experienced by 38.9% of women ( n = 7) with high-level injury. Exclusive breastfeeding duration was significantly shorter ( p < .05) in the high-level injury group (3.3 months) compared with women with low-level injury (6.5 months). Conclusion: These results further support the notion that spinal cord injury (particularly at or above T6) disrupts lactation and is associated with shorter breastfeeding duration. Autonomic dysreflexia should be addressed in prospective mothers with high-level spinal cord injury.

Funder

Canadian Institutes of Health Research

Rick Hansen Institute

Craig H. Neilsen Foundation

Publisher

SAGE Publications

Subject

Obstetrics and Gynaecology

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