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


Based on the available evidence, to optimize breastfeeding initiation, key considerations for maternity services that provide intrapartum care should include implementation of the BFHI Ten Steps and BFHI accreditation. Key considerations for individual practitioners who provide intrapartum care are listed above.

Maternity care providers should ensure that as far as possible, all practices that take place in the peripartum period optimize the use of evidence-based practices that enhance breastfeeding. It is likely that a range of measures need to be in place. Single strategies, such as providing breastfeeding support or written materials to women[22] or educating health professionals,[22] are unlikely to increase breastfeeding initiation as stand-alone measures.

A general approach of encouraging all women to breastfeed soon after birth should be taken, with attention to the identification and offer of extra support for those women at higher risk for not successfully initiating and continuing breastfeeding. This may be particularly important in busy birth suite environments where staff have very little time, and where there is often pressure for women to vacate the birthing room as soon as possible. In addition to the psychosocial and demographic factors that indicate women at higher risk for not initiating breastfeeding, peripartum risk factors may include women who have a long labour, a prolonged second stage of labour, those who receive intramuscular opiate analgesia, those who have an instrumental or caesarean birth, and women unable to have immediate and prolonged skin-to-skin contact with their newborn infant.


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