Why do women stop breast-feeding? Results from a contemporary prospective study in a cohort of Australian women.

BACKGROUND/OBJECTIVES: Australian guidelines recommend infants be breast-fed for at least their first year of life; however, for a variety of reasons many mothers cease breast-feeding before this age. The objective of this study was to determine the reasons why women stop breast-feeding their infant completely, in relation to the age of the infant. SUBJECTS/METHODS: Primiparous Australian women aged between 18 and 40 years underwent a self-administered questionnaire-based birth cohort study on infant-feeding attitudes, behaviours and feeding patterns. Data were extracted from the demographic questionnaire and from questionnaires administered at 2, 4, 6 and 12 months of infant age between October 2010 and September 2011. RESULTS: Breast-feeding initiation in this cohort was 97%; however, by 52 weeks of infant age 46% of mothers had completely ceased breast-feeding. In those mothers who had ceased breast-feeding before 26 weeks the most common reason was 'I did not have enough milk'. In those mothers who had completely stopped breast-feeding between 26 and 52 weeks the most common reason reported as being very important in the decision to cease breast-feeding was 'My baby lost interest'. CONCLUSIONS: Maternal concerns regarding breast trauma, milk supply and infant satiety were central mediators of breast-feeding duration among these Queensland women. Further research into the antecedents of sucking pathologies and reasons for nipple trauma is indicated. Health professionals can assist women to recognise cues of hunger and satiety in their infants and understand the dynamics and natural history of breast-feeding to prolong breast-feeding relationships.

Antenatal breastfeeding intention, confidence and comfort in obese and non-obese primiparous Australian women: associations with breastfeeding duration.

BACKGROUND/OBJECTIVES: Maternal adiposity is known to affect breastfeeding initiation and duration via both antenatal and postnatal factors. This study investigates associations between maternal pregravid body mass index (BMI), breastfeeding duration and antenatal breastfeeding confidence, intention and social comfort among primiparous Australian women. SUBJECTS/METHODS: Women in their first pregnancy (n=462) were recruited by convenience sampling in Queensland, Australia. Participants responded to an antenatal and six postnatal questionnaires during their infants' first year between June 2010 and March 2012. Maternal pregravid BMI was examined against breastfeeding duration, participants' antenatal infant feeding intentions and measures of breastfeeding confidence and social comfort. RESULTS: Breastfeeding initiation in this cohort was 97%, but 46% of mothers had ceased breastfeeding at 52 weeks postpartum. Breastfeeding duration differed significantly (χ(2) (2)=7.21, P=0.007) between normal, overweight and obese women. No differences were found in antenatal intention for feeding type nor intended breastfeeding duration by one-way ANOVA (F(2,178)=1.77, P=0.17). More than half of the pregnant respondents anticipated social discomfort breastfeeding in public, with obese women significantly more likely to anticipate discomfort breastfeeding in the presence of close female friends, (χ(2) (1)=5.53, P=0.019). CONCLUSIONS: This study confirmed the risk of premature cessation of breastfeeding for obese mothers. Interventions during pregnancy that address body image issues in relation to breastfeeding may facilitate breastfeeding success for obese mothers and their infants and accrue short- and long-term health benefits for both.