Why Don’t Moms Meet Their Own Breastfeeding Goals?

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?
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Photo credit: Jerry Bunkers on flickr


Robin R.
Robin R.5 years ago

We are completely torn between the guilt we are feel if we are unable to breastfeed (or God forbid we CHOOSE not to!) and the embarassment of people glaring at us for doing it in public. No matter what you do as a mother (or as a woman in general, really), you fail.

Robin R.
Robin R.5 years ago

Honestly, I think one big reason has to be that the general public STILL frowns on it. People are uncomfortable seeing a woman feeding her child. I kept thinking, they have to know that this is what breast are actually for, right?" I was shocked at how even close friends thought I needed to ask if it was okay or to go do it in the bathroom or car. My answer was always, "Do YOU eat in the bathroom? Do YOU ask permission to eat in public?" After all, THEY were obviously the ones who were uncomfortable, so they should probably examine WHY with their psychologist...but when bombarded with such embarassing and aggravating conversations, I had trouble relaxing enough to actually do it.

Lika S.
Lika P5 years ago

My son drew blood while still in the hospital. Then I also dried up at 6 months, and couldn't do it anymore, not even with a pump.

At least he got 6 months, and only the first month was primarily breast feeding.

Jennifer M.
Jennifer M5 years ago

Support, support, support. If women don't have it, they give up. Like the TIME cover. Who gives a shit about that?? It is normal in every other culture but ours pretty much. Breasts need to stop being portrayed as sexual objects. Their soul purpose is to nourish a child. Hospitals are also to blame. Most of them just give formula without a second thought. It's just plain wrong. EVERY woman should at least try breastfeeding. If you can't do that, don't have a kid. Women who choose formula without even trying the breast will always put themselves first, and that's not okay. Yep, I said it!

Lynne Brittany
Lynne B5 years ago

I bf my first child for 31/2 months then had to go back to work, expressing didn't work out so we had to find a formula and synthetic teat that he would tolerate, it was a nightmare

I bf my second child for 41/2 months then he became too hungry that he was feeding from me every hour. I became too sore to carry on. He took to formula instantly

I wish I could have carried on longer but it isn't always possible.

Ted H.
Edwin Hopkins5 years ago

This touches a nerve that remains raw after nearly a quarter century. When my wife and I were expecting our first child, my wife felt committed to breast-feeding. It seemed only natural and the proper birth-right of her womanhood. Our prenatal classes vigorously reinforced that commitment and the hospital staff at delivery were all encouraging and fully supportive. My wife's milk just would not come. For the first month of our son's life my wife vainly tried to breast-feed him exclusively. We eventually found a consultant but the advice proved ineffectual. After a full month my wife finally gave up on trying what she had expected to come entirely naturally and tearfully switched our son to formula. He then thrived.

For a full decade after, my wife lashed herself at the memory of how she nearly "starved" our son and would break into spontaneous tears. I could never quite fully comfort her from this memory. Even today she cannot look at photographs of our son at one month old, his emaciated face haunts her still.

Please give a care when discussing breast-feeding. For a woman to fail at what she expects to be an entirely natural matter-of-course part of her womanhood can be a deeply devastating experience. Too many of the enthusiastic previous comments rub salt into an old wound.

Betsy M.
Betsy M5 years ago

I met my breastfeeding goals, but it was despite the medical staff. They paid lip service to how supportive they were, but they had a very negative impact on my nursing. Meanwhile they laughed at younger women who supposedly could not nurse.
BTW, it's not so much that we are "bottomless wells of bitterness and self centered agrandisement (sic)? ... fallen to the point where their self appointed vanguard need "lactation professionals" to use their own titties!" WTF? LOL!!
Medical personnel will use any (or no) excuse to give glucose to a newborn. It is difficult to get them to admit it. Most women whose infant supposedly does not know how to latch is just reacting from the sugar jolt. Infants who are recovering from birth medications have problems. Infants who are rubbed down with cold, toxic solutions, kept from Ma, toxic junk in their eyes, stabbed in the feet... No wonder they get confused & disoriented.

Nicola Payne
Nicola Payne5 years ago

I was three months premature so I was too weak to latch. Therefore, my mum used a breast pump so that I still got her milk. If she hadn't have done that, I wouldn't have received all her natural immunity to things.

Personally, I don't see difficulty as an excuse for not giving your child your own breast milk. If the baby doesn't latch on to the breast then a breast pump can always be used. No matter how many formula milks you give, they just won't match up to breast milk in my opinion.

Hilary S.
Hilary S5 years ago

"breastfeeding goals"? the story makes this sound like trying to meet a business target! how about plans or wishes or preferences?

overall, this article does highlight the gradual erosion of choices for american women, and for their agency over their own bodies. i see it as an extension of attempts to outlaw abortion and discontinue family planning centres in the us.

Alice E.
Alice E5 years ago

Women in the USA don't see other women breastfeeding often and this is one reason they are unsuccessful. Even the woman in photo with this article doesn't know how to hold her baby correctly for a successful latch. There are so many ignorant people commenting here, I almost don't even want to add my comment.

Bernie P....It's normal for a newborn to be hungry and need to be fed every 2 hours. His little stomach is as big as a marble and colostrum and breastmilk are digested very quickly.

I wish it were possible for all new mothers to breastfeed. It would be most helpful if we could stop looking at breasts as sex objects and realize their first purpose is to feed infants. Then we could provide nurturing assistance to women who need it. Many women give up, only because they lack help and guidance from an experienced woman. Doesn't necessarily mean it has to be an LC. Then if a woman needs to supplement or replace breastmilk...thank heaven we have good formula. The most important thing is to feed the baby. Not meet our "goals."