This week the American Academy of Pediatrics released the findings of a study on factors that contribute to mothers meeting their own breastfeeding goals. The study found that 85% of mothers intend to breastfeed exclusively for 3 months or more. However, only 32.4% of those mothers achieved that goal.
The study found that women over the age of 24, who are white, college educated, married, non-smoker, and not obese have the best chance of meeting their breastfeeding goals. It showed that women who had more than one child had a greater incidence of success. The study also showed in-hospital practices, in particular the supplementation of babies with something other than breast milk while in the hospital, meant that moms were less likely to be successful in exclusively breastfeeding after leaving the hospital.
What do the results tell us?
The results of this study confirm that breastfeeding support, especially in the critical first few days after the birth, is an important factor in breastfeeding success. Hospitals need to ensure that the nurses and doctors that work with mothers and babies, especially first time mothers, have significant training in lactation and have 24 hour access to International Board Certified Lactation Consultants (IBCLC) who can work with mothers who are having difficulty. Getting help from an IBCLC, who will follow the evidence-based professional protocols for supplementation, will ensure that babies are not being given infant formula because of a nurse or doctor’s insufficient knowledge on breastfeeding.
Hospitals need to work towards the implementation of key Baby-Friendly hospital practices, such as:
- initiating breastfeeding within one hour of birth
- no food/drink other than breast milk
- baby rooming-in with mother
- breastfeeding on demand
- not giving a pacifier
- providing information on breastfeeding support
As breastfeeding advocate and Human Milk 4 Human Babies founder Emma Kwasnica notes, the implementation of these practices is entirely insufficient at the moment:
We now have the evidence to prove that giving anything other than the breast to a newborn is the key factor in the success of the breastfeeding relationship. Even more appalling is the fact this disruption happens during the very first two days of life. When 80% of hospitals in the USA are supplementing the newborn baby by Day 1 or 2, the mother-baby unit doesn’t even stand a chance; they haven’t even left the hospital before the future success of their breastfeeding relationship has already been jeopardized. This is completely unacceptable, all the more so because these women wanted to breastfeed.
The results also tell us that more work is needed to understand the reasons why mothers do not meet their own breastfeeding goals. The study showed that even with ideal hospital conditions and characteristics of the mother that were most aligned with breastfeeding success, the majority were still not meeting their breastfeeding goals.
In addition, more work is needed to create conditions where mothers feel like they can breastfeed their baby for a duration that aligns with the recommendations from major public health organizations like the World Health Organization and the American Academy of Pediatrics (i.e. exclusive breastfeeding for six months). This includes easy access to IBCLCs even after the mom has left the hospital, increased lactation training for other health professionals, and maternity leave that allows mothers to be with their newborns to breastfeed them during those critical first few months.
Finally, we need more work on the development of human milk banks, so that when hospitals do need to provide supplements (in the rare situations where it is truly necessary), they can have human milk available.
What can parents do?
Parents who want their babies to be exclusively breastfed should ensure that they have a strong support network both within and outside their family, which includes qualified lactation professionals. They should seek out hospitals that have implemented Baby-Friendly practices (ideally) or at least insist on those policies being followed in their hospital. They can ensure they have an IBCLC ready to support them immediately after the birth of their child, including coming to the hospital as necessary to help avoid necessary supplementation with infant formula.
If you are a mother, did you meet your own breastfeeding goals? What factors do you think contributed to either meeting or not meeting those goals?
Photo credit: Jerry Bunkers on flickr