As noted in our previous blog, Global Breastfeeding Rates – How Do They Vary?, the rates of families choosing breastfeeding as the method to feed their baby differs across the world. In this post we explore some of the factors that can influence different infant feeding choices.
For each woman and family, many different experiences and factors are at play within their decision on how to feed their baby. This is rarely a decision that is taken lightly, and we understand the importance of supporting parents through this.
According to a number of systematic reviews of the literature and large observational studies, the below factors have proven impactful on breastfeeding initiation and duration rates.
Further to the factors above, many studies have approached mums directly to hear about their experiences in their own words. Below we explore a few studies that connected with mums to find out what influenced the unexpected early cessation of their breastfeeding journeys.
A large study conducted in the US found that concerns around milk supply / breast milk not being enough to satisfy baby was a leading reason mums ceased breastfeeding earlier than they wished, this made up 43-55% of responses, depending on the age that weaning occurred.
A later study originating from the same facility revisited this question. In this group they found that 60% of mums stopped breastfeeding earlier than they wanted to. The reasons reported were difficulties with breastfeeding, concerns around infant nutrition and weight, illness / needing to take medication and difficulties with the effort required to pump breast milk.
A study conducted via self-reporting of mums’ own experiences in the UK found many factors were associated with breastfeeding cessation. 82% of the listed reasons fell into the following categories: it was physically difficult, it was painful, it was inconvenient, body image concerns, embarrassment, pressure from others to stop or to share feeding, lack of support and medical reasons.
In a study in Taiwan, mums’ experiences of breastfeeding were documented via telephone interviews. In this group, the prevailing reasons associated with early cessation of breastfeeding were lack of tertiary education, this being mum’s first baby, feeling they had low milk supply, mum and baby being separated for a period of time after birth, maternal medical condition, inconvenience, fatigue due to breastfeeding and baby centered issues that included problems with latching and feeding.
From the reasons above we can see many factors that have the potential to be improved by more awareness and support for families at this time. We can see the importance of support from peers and family members, as well as from health professionals. Lastly, we recognize again the impact that concerns around milk supply and baby’s weight gain can have on feeding choices. We have explored the complexities of low and high milk supply in our previous blogs in more detail, follow the links below to read more.
Whilst we have highlighted the most frequently recorded considerations for infant feeding within the literature, many more factors can be involved in these decisions. It is important that we, as a society, show understanding of the complexity of these decisions, not to mention the emotional impacts they carry. If we can provide extra understanding and begin to work together to combat some of the prevailing issues experienced by families around infant feeding, we can help to make these choices and the subsequent feeding practices easier for families.
Follow the links below to explore the issues of low and high milk supply in more detail:
References
Asimaki, E., Dagla, M., Sarantaki, A., & Iliadou, M. (2022). Main Biopsychosocial Factors Influencing Breastfeeding: a Systematic Review. Maedica (Bucur), 17(4), 955-962. https://doi.org/10.26574/maedica.2022.17.4.955
Brown, A. (2014). Maternal trait personality and breastfeeding duration: the importance of confidence and social support. Journal of Advanced Nursing, 70(3), 587-598. https://doi.org/https://doi.org/10.1111/jan.12219
Brown, A., & Jordan, S. (2013). Impact of birth complications on breastfeeding duration: an internet survey. Journal of Advanced Nursing, 69(4), 828-839. https://doi.org/https://doi.org/10.1111/j.1365-2648.2012.06067.x
Brown, A., Rance, J., & Bennett, P. (2016). Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing, 72(2), 273-282. https://doi.org/https://doi.org/10.1111/jan.12832
Brown, A., Raynor, P., & Lee, M. (2011). Healthcare professionals’ and mothers’ perceptions of factors that influence decisions to breastfeed or formula feed infants: a comparative study. Journal of Advanced Nursing, 67(9), 1993-2003. https://doi.org/https://doi.org/10.1111/j.1365-2648.2011.05647.x
Bürger, B., Schindler, K., Tripolt, T., Griesbacher, A., Stüger, H. P., Wagner, K.-H.,…Wolf-Spitzer, A. (2022). Factors Associated with (Exclusive) Breastfeeding Duration—Results of the SUKIE-Study. Nutrients, 14(9).
Chang, P.-C., Li, S.-F., Yang, H.-Y., Wang, L.-C., Weng, C.-Y., Chen, K.-F.,…Fan, S.-Y. (2019). Factors associated with cessation of exclusive breastfeeding at 1 and 2 months postpartum in Taiwan. International Breastfeeding Journal, 14(1), 18. https://doi.org/10.1186/s13006-019-0213-1
Cohen, S. S., Alexander, D. D., Krebs, N. F., Young, B. E., Cabana, M. D., Erdmann, P.,…Saavedra, J. M. (2018). Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis. The Journal of Pediatrics, 203, 190-196.e121. https://doi.org/https://doi.org/10.1016/j.jpeds.2018.08.008
Li, R., Fein, S. B., Chen, J., & Grummer-Strawn, L. M. (2008). Why Mothers Stop Breastfeeding: Mothers’ Self-reported Reasons for Stopping During the First Year. Pediatrics, 122(Supplement_2), S69-S76. https://doi.org/10.1542/peds.2008-1315i
Meedya, S., Fahy, K., & Kable, A. (2010). Factors that positively influence breastfeeding duration to 6 months: A literature review. Women and Birth, 23(4), 135-145. https://doi.org/https://doi.org/10.1016/j.wombi.2010.02.002
Odom, E. C., Li, R., Scanlon, K. S., Perrine, C. G., & Grummer-Strawn, L. (2013). Reasons for Earlier Than Desired Cessation of Breastfeeding. Pediatrics, 131(3), e726-e732. https://doi.org/10.1542/peds.2012-1295
