Why Do Women Fail to Meet Their Own Breastfeeding Goals?

William T. Basco, Jr., MD


June 05, 2013

Reasons for Earlier Than Desired Cessation of Breastfeeding

Odom EC, Li R, Sconlon KS, Perrine CG, Grummer-Strawn L
Pediatrics. 2013;131:e726-732

Study Summary

At more than 70%, the frequency of initiating breastfeeding in the United States is high. However, attrition rates in the first weeks and months after discharge from the newborn nursery are substantial. Odom and colleagues sought to compare the breastfeeding duration intentions of mothers with achieved breastfeeding durations and identify reasons for termination of breastfeeding before the mothers' stated goals for breastfeeding duration. Data were obtained from a longitudinal cohort study of mothers conducted from 2005 through 2007. Women were recruited in their third trimester, were at least 18 years old, and both mother and infant were without chronic medical conditions. The infants were at least 35 weeks gestation.

The study was conducted entirely with mailed surveys, with mothers completing a prenatal questionnaire and 10 interval questionnaires over the course of the first 12 months postpartum. At each of the postnatal surveys, the mothers were asked whether they were still breastfeeding, and if they were no longer breastfeeding, they were asked to list the reasons that they had stopped. The mothers were asked, "Did you breastfeed as long as you wanted to?"

The survey offered 32 reasons for cessation of breastfeeding, and mothers rated them on a Likert scale of 1 to 4. Answers were dichotomized as "1 or 2" vs "3 or 4" for analysis. Although the 32 questions were very specific, they were grouped into categories such as problems with lactation; lifestyle issues; difficulties with pumping; medical, nutritional, or psychological concerns of the mother; concerns about the infant; and infant self-weaning.

A logistic regression analysis included the 32 reasons for stopping breastfeeding and their association with mothers not meeting their breastfeeding duration goals. The final analysis accounted for maternal age; previous pregnancies; race; maternal marital status; maternal education; participation in the Women, Infants, and Children (WIC) supplemental nutrition program; an additional measure of household poverty; and the mother's stated goal for intended breastfeeding duration (number of months).


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