If Breast Is Best, Why Aren't More Mothers Breastfeeding?

From the WebMD Archives

Nov. 6, 2000 -- The American Academy of Pediatrics calls breastfeeding "the ideal method of feeding and nurturing infants" -- yet, relatively few U.S. women breastfeed. In a recent study published in the November issue of the journal Pediatrics, a little more than 44% of women decided to breastfeed, and by the time the baby was 6 months old, only 13% were still breastfeeding. Why?

The researchers, who surveyed almost 250 women, found women often stop breastfeeding -- or don't even start -- because they know they'll need to return to work.

It is possible to breastfeed if you work full time, says Paul A. Gluck, MD, an Ob-Gyn. A few lucky mothers who work in family-friendly environments can visit their child in on-site day care and breastfeed during breaks. But if that isn't available, "once the breast milk is established, a woman can combine breast and bottle feeding," Gluck tells WebMD. "This is not as good as breastfeeding exclusively, but it is much better than not breastfeeding at all." Gluck is vice chair for the American College of Obstetricians and Gynecologists for the Florida section and co-director of the Baptist Health Systems of South Florida Foundation.

Also, family members can offer a great deal of support for new mothers -- along with a lot of advice and influence, the survey shows. As a matter of fact, the mother's major source of information about breastfeeding was her family about 40% of the time. And when mothers chose to bottle feed, it was often due to perceptions of the father's attitudes and concerns about the quantity of breast milk.

Maria Egusquiza, MD, says grandmothers often influence the decision on breastfeeding as well. "Many women of that generation didn't breastfeed themselves, so we need to educate them and explain its benefits. We try to talk to the whole family and clear up any misinformation," she says. Egusquiza is a pediatrician in private practice on staff at Baptist Hospital of Miami.

The key to turning the tide in favor of more breastfeeding lies not only in education, but also in the timing of education. "The most important thing we learned is that we need to target education to mothers early in pregnancy or even before pregnancy, in order to attain higher rates of breastfeeding," lead author Samir Arora, MD, tells WebMD. "We found 78% of people made their decision either before pregnancy or within the first trimester." Arora is associate director of Community Health Net, a primary care practice in Erie, Penn.


"Education of mothers, families, especially fathers, and health care professionals regarding the benefits of breastfeeding, as well as how to overcome barriers, would have a positive impact on the number of mothers choosing to breastfeed," the authors conclude.

Also, breastfeeding appears to be more of a case of nurture instead of nature. "Breastfeeding isn't innate, it's a skill to learn," says Paula Schreck, MD, a pediatrician on staff at St. John Hospital and Medical Center in Detroit. At her hospital, a breastfeeding consultant is available six days a week on the mother-baby unit, and at all hours via phone. "A new mother may not know how to help the baby latch on to her breast. She needs to take the time to learn her baby's signals. For example, when the baby pulls away, that may mean it needs to be burped." A specially trained consultant can spend hands-on time with the mother and baby, helping them get started on the nursing relationship.

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