A Closer Look at Breastfeeding Habits

Breastfeeding goals may be unrealistic but a family centered approach would be best

(RxWiki News) Official medical recommendations are to breastfeed babies exclusively for a baby's first six months, but is this too lofty a goal for some women? What happens when reality meets idealism?

A new report reveals that a better approach than these blanket recommendations is to encourage family and healthcare provider discussions that plan together for how to feed a new baby.

"Breastfeed your baby exclusively for six months - or as close as is possible."

Pat Hoddinott, of the Health Services Research Unit at the University of Aberdeen in the U.K., led the study, in which the authors note that

The researchers conducted 220 in-person interviews with 36 women and 26 of their partners, as well as one of their sisters, eight of their mothers and two healthcare professionals. All but one of the women expecting planned to breastfeed.

The researchers did each interview approximately every four weeks from the women's final month of pregnancy until their babies were six months old to see how their views changed and how breastfeeding affected the whole family.

They found that the realities of women trying to breastfeed for six months didn't always pan out for a variety of reasons, and so adjustments to health care providers' approach to breastfeeding might be in order.

"Immediate family well-being is the overriding goal rather than theoretical longer term health benefits," the authors write. "Feeding education is perceived as unrealistic, overly technical and rules-based, which can undermine women's confidence."

For example, one women said breastfeeding was made to "sound so easy" and another said it was said to be a "a lovely bonding experience," when neither of them found these statements to be the case for them.

Another women said women likely give up because the all-or-nothing approach is too difficult with the realities of everyday life. Several of the partners said the information they received about breastfeeding before the baby arrived wasn't sufficient for the realities of it.

A better approach, the general consensus of the interviews revealed, was that in addition to technical information on how to breastfeed, women and their partners needed more help with discussing, ahead of the baby's arrival, the emotional issues involved with breastfeeding.

The authors noted as well that parents may change the way they feed their babies, moving on to solids or offering other liquids instead of breastfeeding, during "pivotal" but normal changes in baby's crying, feeding or sleeping habits to help themselves and their families cope with the change.

They therefore called for more incremental goals for women and families and a more proactive approach before birth that includes "realistic, interactive discussions with appropriately skilled healthcare providers and peers before and after birth."

"Adopting idealistic global policy goals like exclusive breast feeding until 6 months as individual goals for women is unhelpful," they write. "More achievable incremental goals are recommended."

In anticipation of potential backlash about this article coming across as "anti-breastfeeding," Dr. Trish Groves, the editor in chief of BMJ Open where the article appeared online March 14, offered her comments.

"This study is not against breast feeding: far from it," Groves said. ""We hope that parents, and anyone supporting mothers with breast feeding, will read the full paper. It provides first person accounts of how families actually feed their babies and how they feel about it, and the researchers have discussed their findings sensitively and in great depth."

The article is available to the general public free of charge at BMJ Open. The study was funded by NHS Health Scotland, and the Health Service Research Unit at the University of Aberdeen is supported by the Chief Scientist Office of the Scottish Government Health Directorates. The authors declared no competing interests.

Review Date: 
March 14, 2012