Accessing Breastfeeding Advice for First-Time Mothers
by Anne Eglash MD, IBCLC, FABM
How important is ease of access to breastfeeding advice for first-time mothers?
There is plenty of research confirming that breastfeeding support after leaving the hospital is associated with increased duration of breastfeeding. The study for this week evaluated the association between ease of access to breastfeeding advice for first time mothers and breastfeeding establishment and duration.
The authors for this week’s study used data from the First Baby Study, a 3-year longitudinal cohort study from 2009-2011 of pregnant primiparous women in Pennsylvania, USA. The study collected information via telephone interviews regarding factors associated with breastfeeding establishment and duration. The 2996 participants were interviewed in their third trimester of pregnancy, and at 7 time points after birth- 1, 6, 12, 18, 24, 30 and 36 months postpartum.
The researchers found that 72.5% of participants were breastfeeding at 1 month postpartum, and access to breastfeeding advice was strongly associated with breastfeeding establishment. Among women who reported having no access to breastfeeding advice, 33.3% didn’t try to breastfeed, and 34.8% tried but quit in the first month. Only 31.8% of women with no access to breastfeeding advice were breastfeeding at 1 month compared to 70.7% of women who had ‘a little or some’ access to breastfeeding advice, and 75% of women who had access to breastfeeding advice ‘most or all of the time’. Among women who breastfed for over 6 months, 48.2% reported having access to breastfeeding advice ‘most or all of the time’, vs 26% of women who breastfed for less than 6 months. Only 14.6% of women who reported ‘none’ for breastfeeding advice were still breastfeeding at 6 months postpartum.
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- Women who delivered preterm were more likely to report a high level of access to breastfeeding advice as compared to women who did not deliver preterm.
- Mothers who were younger and in the lowest education group were more likely to report having no access to breastfeeding advice.
- Women who reported having access to breastfeeding advice were more likely to have high levels of social support during pregnancy.
- The most common reasons for early breastfeeding cessation were ‘not enough milk’ and ‘the baby would not latch’.
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Background and aims
First-time mothers often need help with breastfeeding and may feel isolated and uncertain about whom they can turn to for help with breastfeeding challenges. Exploration of whether access to breastfeeding advice helps new mothers initiate and continue breastfeeding is necessary. This study investigated the associations between ease of access to breastfeeding advice for first-time mothers and breastfeeding initiation and duration.
This was a prospective, longitudinal cohort study of 3,006 women who delivered their first child in Pennsylvania, USA; with prenatal and postpartum interviews. At 1-month postpartum participants reported the extent to which they had access to “Someone to give you advice about breastfeeding if you needed it”, via a 5-point scale ranging from “none of the time” to “all of the time”.
There were 132 women (4.4%) who reported that they had access to someone to give them advice about breastfeeding “none of the time”; 697 (23.3%) reported access “a little of the time” or “some of the time”; and 2,167 (72.3%) reported access “most of the time” or “all of the time”. While the majority of the new mothers were breastfeeding at 1-month postpartum (72.5%), less than half were still breastfeeding at 6-months postpartum (44.5%). The higher the level of access to advice about breastfeeding the more likely women were to establish breastfeeding by 1-month postpartum and to still be breastfeeding at 6-months.
For first-time mothers, ease of access to someone who can give them advice about breastfeeding facilitates breastfeeding establishment and continuation.
This study demonstrates how access to breastfeeding advice has the power to impact breastfeeding rates.
The authors found that younger, less educated, unmarried women were more likely to have limited or no access to breastfeeding advice.
Rather than just giving out written information about breastfeeding the authors suggest helping pregnant individuals develop a ‘breastfeeding support plan’, so they know who to contact with breastfeeding concerns or questions. Routinely advising and helping with breastfeeding support plans prenatally is also a health equity strategy, as people with higher education and income may have greater self-efficacy in developing a plan on their own than those at risk for less breastfeeding.
Breastfeeding advice can come from social media, friends, family, support groups, or from their primary care office.
Because primary care offices provide support and care for medical concerns, it is logical that they carry the responsibility to be a central resource for evidence-based breastfeeding advice.
The authors point out the World Health Organization’s 2021 Global Score Card on Breastfeeding Support specifically calls for healthcare professionals to provide breastfeeding support.