Breastfeeding Difficulties and Risk for Early Breastfeeding Cessation.

Gianni Gianni,Liotto Liotto,Bettinelli Bettinelli,Mosca Mosca,Manfra Manfra,Bezze Bezze,Roggero Roggero,Morniroli Morniroli,Sorrentino Sorrentino,Crippa Crippa,Plevani Plevani,Marchisio Marchisio,Cavallaro Cavallaro,Raffaeli Raffaeli,Colombo Colombo,Villamor Villamor

doi:10.3390/nu11102266

Abstract

Although breast milk is the normative feeding for infants, breastfeeding rates are lower than recommended. We investigated breastfeeding difficulties experienced by mothers in the first months after delivery and their association with early breastfeeding discontinuation. We conducted a prospective observational study. Mothers breastfeeding singleton healthy term newborns at hospital discharge were enrolled and, at three months post-delivery, were administered a questionnaire on their breastfeeding experience. Association among neonatal/maternal characteristics, breastfeeding difficulties and support after hospital discharge, and type of feeding at three months was assessed using multivariate binary logistic regression analysis. We enrolled 792 mothers, 552 completed the study. Around 70.3% of mothers experienced breastfeeding difficulties, reporting cracked nipples, perception of insufficient amount of milk, pain, and fatigue. Difficulties occurred mostly within the first month. Half of mothers with breastfeeding issues felt well-supported by health professionals. Maternal perception of not having a sufficient amount of milk, infant’s failure to thrive, mastitis, and the return to work were associated with a higher risk of non-exclusive breastfeeding at three months whereas vaginal delivery and breastfeeding support after hospital discharge were associated with a decreased risk. These results underline the importance of continued, tailored professional breastfeeding support.

Highlights

Breastfeeding is associated with improvement of infants’ survival and significant health benefits both for infants and mothers in a dose-response manner [1,2,3]
552 (70%) completed the study and the online questionnaire whereas the remaining 240 mothers did not complete either the study or the online questionnaire since it was not possible to reach them by telephone after hospital discharge
Multivariate binary logistic regression showed that the maternal perception of not having a sufficient amount of milk, infant’s failure to thrive, mastitis, and the return to work were associated with a higher risk of non-exclusive breastfeeding at three months whereas vaginal delivery and breastfeeding support after hospital discharge were associated with a decreased risk (Table 5)

Summary

Introduction

Breastfeeding is associated with improvement of infants’ survival and significant health benefits both for infants and mothers in a dose-response manner [1,2,3]. There is a need for increasing the health care professionals’ awareness of the intrinsic factors associated with early breastfeeding cessation and for gaining further insight into the related modifiable risk factors [5]. Several determinants of breastfeeding have been described within a complex framework, including structural settings and individual factors that are involved at multiple levels [6]. The experience of breastfeeding difficulties greatly contributes to early breastfeeding cessation and causes mothers to be less likely to breastfeed a future child [7]

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Discussion

Conclusion