Breastfeeding fraught with early challenges for most first-time mothers

Strategies should be developed for evaluating infant breastfeeding and alleviating the concerns of the new, breastfeeding mothers soon after birth, recommend the researchers, who report their findings online this week in the journal Pediatrics.

“Findings from our study indicate that certain breastfeeding problems or concerns are experienced almost universally by first-time mothers, and some of those problems greatly increase the chances they will stop breastfeeding earlier than they planned,” said study co-author Caroline Chantry, a pediatrician at the UC Davis Medical Center, where the research with the first-time mothers was based.

“If we can enable mothers to achieve their breastfeeding goals, we will have a healthier nation,” Chantry said. She noted that although 75 percent of mothers in the United States initiate breastfeeding, only 13 percent of those women ultimately breastfeed exclusively for the recommended first six months of the child’s life.

The new study, based on a sample of 532 first-time mothers, included interviews while the women were pregnant and at six other times between birth and 60 days after the babies were born.

Ninety-two percent of the new moms reported at least one breastfeeding concern three days after birth. The most predominant concern was that the infants were not feeding well at the breast (52 percent), followed by breastfeeding pain (44 percent) and perceived lack of sufficient milk (40 percent).

The researchers collected reports of thousands of breastfeeding problems and concerns from the mothers. The concerns that were reported at interviews conducted at days three and seven after the baby’s birth were strongly associated with the moms’ subsequent decisions to supplement with formula or stop breastfeeding altogether.

“These interviews at three and seven days were conducted at a time when there may be a gap between hospital- and community-based lactation support resources,” said co-author Kathryn Dewey, a UC Davis nutrition professor and authority on maternal and infant nutrition.

“Based on these findings, we would recommend that first-time moms, in particular, need more support to alleviate breastfeeding concerns that may arise during the first two weeks after their babies are born,” Dewey said. “Such support could help allay any unwarranted concerns and provide new moms with the reassurance and assistance they need to meet their breastfeeding goals.”

Researchers on the study from the Perinatal Institute at Cincinnati Children’s Hospital Medical Center were lead author Laurie Nommsen-Rivers, an assistant professor and UC Davis alumna, and nutritionist Erin Wagner.

Breastfeeding exclusively — rather than using infant formula — is recommended for the first six months after birth by the American Academy of Pediatrics because of the risks of using formula to the health of both infants and moms. For more information, visit the academy’s breastfeeding policy website.

The website for the U.S. Centers for Disease Control and Prevention also offers evidence-based examples of how healthcare providers and communities can support breastfeeding.

This study was supported by grants from the National Institutes of Health (NIH HD063275-01A1) and (MC 04294) and the Maternal and Child Health Research Branch, DHHS (C 04294).

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