Most pregnant women who say they intend to exclusively breastfeed their infants for at least 3 months fail to do so, say researchers whose findings appear online today in Pediatrics.
In a survey from 2005 through 2007, researchers with the US Centers for Disease Control and Prevention contacted 1457 pregnant women who expressed an intention to breastfeed exclusively. The investigators asked these women how long they planned to breastfeed exclusively and then followed up with monthly surveys over the next year. More than 85% of the women said they planned to exclusively breastfeed for 3 months or more; only 32.4% reached that goal. About 15% abandoned their goal by the time they left the hospital. Among the 17.2% of women who intended to exclusively breastfeed for 7 months or more, only 11.6% did so.
Factors that improved a mother’s chances of prolonged exclusive breastfeeding were being married, previously having had a baby, and beginning breastfeeding within 1 hour of birth. Obesity, smoking, and longer duration of breastfeeding episodes were associated with not maintaining breastfeeding exclusivity.
Hospital practices also may play a negative role in mothers’ attempts to achieve exclusive breastfeeding. The researchers noted that although all the mothers wanted to breastfeed exclusively for at least some period of time, 40% reported that their infants received supplemental feedings in the hospital, which is inconsistent with best practices in maternal care. Hospital supplementation is associated with delayed onset of lactation, suboptimal breastfeeding practices, perceived problems with breastfeeding during the hospital stay, and shorter durations of exclusive breastfeeding. About 78% of US hospitals routinely give supplements to healthy breastfeeding infants.
The World Health Organization and the American Academy of Pediatrics recommend that mothers breastfeed exclusively (only breast milk and medications or micronutrient supplements, but no other liquids or solids) for about the first 6 months of an infant’s life.