Post-natal Care
Barriers to Breastfeeding – A Global Survey on Why Women Start and Stop Breastfeeding
Marko de Jager,1 Katy Hartley,2 Juliette Terrazas3 and Julia Merrill4
1. Director of Clinical Marketing, Philips AVENT, Philips Consumer Lifestyle, Amsterdam; 2. Director, The Philips Center for Health & Well-being, Amsterdam; 3. Research Director, One Voice Measurement, New York; 4. Senior Research Associate, One Voice Measurement, New York
Abstract
Breastfeeding is vitally important for the healthy development of the newborn infant. Despite many countries supporting the WHO recommendation that infants be exclusively breastfed for the first six months of life, research shows limited success in both developed and developing nations. Few studies have investigated women’s own perceptions of their breastfeeding attitudes and experiences. Our survey investigated these perceptions in 3,994 women, 18–40 years of age, in the US, Brazil, the UK, Egypt, South Africa, China and India in 2011. There were significant variations between countries. Overall, 94 % of women wanted to start breastfeeding, 88 % did start, but 41 % either never started or stopped within the first six months. For 63 %, the key reason why they wanted to start breastfeeding was the health of their infant. Despite their aspirations, women were struggling with the initiation and continuation of breastfeeding. The main reasons reported for stopping were: perceived insufficiency of milk supply (40 %), the baby no longer wanting to nurse (24 %), painfulness (15 %), time needed to breastfeed (14 %) or to pump (7 %), need to go back to work (10 %) and feeling awkward breastfeeding outside the home (9 %). This article argues how most of these barriers to breastfeeding for longer may be addressed through reinforcing existing parental support programmes and an increased acceptance of breastfeeding in the workplace and in public.
Keywords Breastfeeding, survey, prevalence, duration, barriers
Disclosure: Marko de Jager and Katy Hartley are employees of Philips AVENT. Juliette Terrazas and Julia Merrill are employees of One Voice Measurement. Received: 20 January 2012 Accepted: 31 January 2012 Citation: European Obstetrics & Gynaecology, 2012;7(Suppl. 1):25–30 Correspondence: Marko de Jager, Philips AVENT, Philips Consumer Lifestyle, Piet Heinkade 55, 1019 GM Amsterdam, The Netherlands. E:
marko.de.jager@
philips.com
Support: The publication of this article was funded by Philips AVENT.
It has been well established that breastfeeding is vitally important for the healthy development of the newborn infant in the first years of life and has long-term health benefits for both the infant and the lactating mother.1–6
For example, epidemiological research has
shown that (exclusive) breastfeeding reduces the risk of infectious diseases in both term and pre-term infants7,8
and the risk of type 2
diabetes, obesity and asthma-related symptoms later in life.9–12 The WHO recommends that infants be exclusively breastfed for the first six months of life and that breastfeeding be continued preferably up to two years of age or beyond.13
Many countries
support the WHO recommendations, have adopted national guidelines and promote the corresponding United Nations Children’s Fund (UNICEF)/WHO Baby-friendly Hospital Initiative14 initiate and sustain successful breastfeeding.3,15
to
In a review, Cattaneo et al. found only slight improvements in Europe from 2002 to 2007 and concluded that breastfeeding rates still fall short of the recommendations.15
However, despite the awareness of, and emphasis on, breastfeeding, epidemiological research conducted on the prevalence of breastfeeding demonstrates limited success with sustaining any – let alone exclusive – breastfeeding for the recommended six months in both developed and developing nations.15–18
© TOUCH BRIEFINGS 2012
Many studies have investigated a variety of demographic, social, biological and psychological factors correlated with (exclusive) breastfeeding duration, often within the confines of a specific country or region. Agreements emerge that shorter breastfeeding duration is associated with lower income, full-time employment, smoking, Caesarean delivery and the infant having received supplementation during the first weeks of breastfeeding, whereas longer breastfeeding duration is associated with adequate professional and peer support, higher educational level, and higher maternal and paternal age.19–27 Few studies have investigated women’s own perceptions related to their breastfeeding attitudes and experiences, and how these perceptions might correlate with breastfeeding success.26,28
A limiting
factor when comparing research on the prevalence of breastfeeding is that no standardised approach has been taken,15
making it more difficult to identify common themes and differences across countries.
We are not aware that any comprehensive standardised survey has been published asking women for their reasons for starting and stopping breastfeeding, as well as comparing economically and culturally diverse countries worldwide. The objective of our research, therefore, was to investigate women’s perceptions of breastfeeding initiation on a global level and distil common themes that could have helped mothers to initiate breastfeeding and sustain it for longer.
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