Breastfeeding Initiation and Birth Setting Practices: A Review of the Literature

Della A. Forster, RN, RM, PhD; Helen L. McLachlan, RN, RM, PhD


J Midwifery Womens Health. 2007;52(3):273-280. 

In This Article


Breastfeeding behaviour is multifactorial in nature, and different factors will be in play depending on individual circumstances. There are, however, certain groups for whom the evidence is consistent, regardless of culture and ethnicity, and for whom the risk of noninitiation of breastfeeding (or early breastfeeding cessation) is higher. It is important that intrapartum care providers are aware of these women, and where possible, offer increased support. Reasons women may give for ceasing breastfeeding very early, even before discharge from the hospital include: pain/discomfort, baby refusing the breast/not interested, concern about supply, attachment difficulties, and mother tired/stressed.[71] Intrapartum care providers may ameliorate some of these factors by early support and encouragement of breastfeeding. Scott et al.[71] suggest that hospitals are "... failing to identify and support those who may be less committed to breastfeeding and/or who have unrealistic breastfeeding expectations... [and that]... it is important that these women be identified and supported while in hospital, as it unlikely that once discharged they will seek out [that support]..."[71,p29]


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