With all its benefits, it’s not hard to see why the World Health Organization (WHO) recommends exclusive breastfeeding until six months of age, and continued nursing until two years of age once solids are implemented. Recent studies have indicated that efforts within hospitals have improved breastfeeding rates. Yet despite the fact that more and more mothers are at least giving breastfeeding a try, not many are sticking it out.
According to the Centers for Disease Control and Prevention (CDC), about three-quarters of women in the United States start breastfeeding their babies from the start. More than half are still nursing when their babies reach a week-and-a-half old. But that percentage drops drastically – to about 16 percent – when you look at the exclusive breastfeeding rates of babies aged at six months. A recent study from Cincinnati Children’s Hospital Medical Center may have found some clues as to why.
“My sense is in my gut that the ability for moms to find adequate breastfeeding support in the community is variable and, in many communities, non-existent,” Dr. Lori Feldman-Winter, a pediatrician at Cooper University Hospital in Camden, N.J., who was not involved in the study, told The Globe and Mail. “We’re going to have many women really wanting to breastfeed and encountering difficulties.”
The study, which was published in Monday’s edition of Pediatrics, seems to confirm Feldman-Winter’s gut instinct with its survey of 533 first-time mothers from one medical center. Prior to delivery, these women were interviewed regarding their plans for breastfeeding. They were surveyed again immediately after they delivered, and again when their babies reached 3, 7, 14, 30 and 60 days old.
When interviewed, the collective group raised 49 unique breastfeeding concerns and concerns. Those concerns were raised, in total, 4,179 different times. The most common ones included nipple or breast pain, concerns over not producing enough milk and general infant feeding difficulties like the infant being fussy or refusing to breastfeed.
“We were surprised by the large number of concerns mothers had, and we were very concerned by how particular concerns were strongly related to giving up with breastfeeding,” like worries about babies not getting enough nutrition,” Laurie Mommsen-Rivers, the study’s senior author from Cincinnati Children’s Hospital Medical Center told The Globe and Mail.
And it seemed that those concerns truly did contribute to the cessation of nursing or supplementation of formula. In fact, about 20 to 50 percent of the mothers stopped breastfeeding or started supplementing with formula sooner than they had originally planned. According to the study authors, those numbers included 166 mothers of 354 that had planned to breastfeed exclusively for two months ended up supplementing with formula between one and two months after their baby’s birth. About 86 of the 406 mothers who had planned to at least partially breastfeed until their child reached two months of age ended up stopping altogether.
What was most interesting, however, wasn’t the numbers themselves, but the link that the authors found when looking at the early breastfeeding concerns and comparing them with the mothers that ended up changing their nursing plan.
According to the researchers, mothers that had expressed concerns over nursing at day 3 were three times more likely to start giving formula before two months of age and nine times more likely to stop breastfeeding altogether than mothers who hadn’t expressed any concerns at that time.
“It’s a shame that those early problems can be the difference between a baby only getting breast milk for a few days and going on to have a positive breastfeeding relationship for a year or longer,” Nommsen-Rivers said. “If we are able to provide mothers with adequate support, 95 percent of all breastfeeding problems are reversible.”
But the resources, while more accessible than they were just a decade ago, are still somewhat limited. And, when you’re trying to cope with a newborn and breastfeeding concerns, it may be hard to find the right resources before getting so frustrated that you’re ready to give up. Nommsen-Rivers believes that soon-to-be moms can better prepare themselves and combat those early challenges by simply searching for support and resources while they are still pregnant. That way, when they do need help, they know where to turn.
Feldman-Winter also stated that mothers who are having trouble can contact the hospital where they delivered. Here they can receive a referral for support, and maybe even receive some encouragement. She also believes that, ideally, support should be integrated into care at the pediatrician’s office – a place that mom and baby will both be spending a lot of time in the coming weeks and months.
“The goal should be to support continued exclusive breastfeeding,” she said, adding that the most important thing for new and expectant moms to know is that “they’re not alone, and it’s really common to struggle in those first few days.”
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