889: Reasons socioeconomically disadvantaged (SED) women quit breastfeeding: can better targeted educational interventions improve breastfeeding ontinuation rates?

Abstract

Most breastfeeding (BF) interventions for SED women focus on BF initiation, which does not necessarily correlate with BF continuation. We investigated reasons for quitting BF among SED women who initiated BF and the perceived usefulness of potential educational interventions in this population. This cross-sectional study occurred in 2016 at a single university-based tertiary care center, which is a Baby Friendly Hospital. SED women without a BF contraindication who delivered non-anomalous singletons were recruited at scheduled appointments within 6 months of delivery. Consenting women completed a validated BF survey. Outcomes included rates of BF with or without formula, perceived BF problems, and perceived usefulness of BF educational interventions. Among women who initiated BF, we compared outcomes between those who chose exclusive formula feeding and those who chose BF with formula supplementation on postpartum day #2 (PPD2). 149 women completed the survey. Though 129 (86.6%) initiated BF, by PPD2, 47 (31.5%) chose formula supplementation, and 51 (34.3%) chose exclusive formula feeding. The majority of women who chose exclusive formula feeding reported initiating BF (60.8%). Among those who initiated BF and added formula by PPD2, formula supplementation was associated with more perceived BF problems, ranging from latch difficulty to concern for low supply. Most women who chose exclusive formula feeding did not report any BF problems. On a 1-5 scale, with 1 denoting strong agreement, all patients initiating BF agreed that future educational interventions should include information on BF benefits, normal neonatal behavior, BF resources, and videos showing latch and BF holds. Women who chose formula supplementation were more likely to “strongly agree” with these proposed interventions than those who chose exclusive formula feeding. The majority of SED women who quit BF did so due to personal preference, not due to having problems with BF. To increase exclusive BF rates in this high-needs population, future educational interventions should focus on issues that the formula supplementation group identified as barriers to exclusive BF: BF benefits, normal neonatal behavior, and access to videos showing how to BF.