Post-natal Care
Table 6: Worries About Breastfeeding and Professional Help With Breastfeeding Proportion of Women Who …
Were worried about how to breastfeed/whether
breastfeeding would be easy Completed breastfeeding class
Felt there was adequate support at the hospital
to help them getting started with breastfeeding Had access to a lactation consultant
23 28 51
41 60
60
73 21 61 64 66 47
91 42 45
All Mothers (%) US (%) UK (%) China (%) Brazil (%) India (%) Egypt (%) South Africa (%) 46
61
51 78
72 48 8 52 68
Table 7: Relationship Between Breastfeeding Duration and Completion of Breastfeeding Class Percentage of Women Who Completed Breastfeeding Class by Breastfeeding Duration
All Mothers
Any Duration (%) 41
0–3 Months (%) 34
US 73 61 UK 21 15 China 61 30 Brazil 51 48 India 8 13 Egypt 18 21 South Africa
54 58
4–6 Months (%) 46
68 30 63 29 16 25 64
7–12 Months (%) 56
79 30 70 54 5
23 63
13–18 Months (%) 31
68 31 59 82 10 18 35
Table 8: Relationship Between Breastfeeding Duration and Availability of Lactation Consultants Percentage of Women Who Had Access to a Lactation Consultant by Breastfeeding Duration
All Mothers
Any Duration (%) 60
0–3 Months (%) 54
US 91 78 UK 42 40 China 45 60 Brazil 72 52 India 68 61 Egypt 34 21 South Africa
72 77
4–6 Months (%) 64
91 50 46 61 71 22 78
Lactation consultants were available to 60 % of the women interviewed, ranging from 91 % in the US to 34 % in Egypt (see Table 6). Table 8 compares the access to lactation consultants with the breastfeeding duration. Except for China, the proportion of women who had access to a lactation consultant fairly consistently increased with increasing breastfeeding duration from 0–3 months up to 7–12 months. These data seem to indicate women were breastfeeding longer if they had had access to a lactation consultant. This would suggest that access to lactation consultants – or, when lactation consultants are least available, other healthcare professionals such as midwives – could increase breastfeeding duration.
Discussion Aspirations
Clearly, women aspire to initiate breastfeeding and they want it for the right reasons, the primary reasons being that it is healthier for the infant, the most natural thing to do and safer than formula milk (see Table 2). Though preferences fluctuate somewhat by country, taken together, these three reasons amount to about 90 % and all pertain to safeguarding the health of the infant, indicating that the awareness of the importance of breastfeeding is well established worldwide.
The US score a surprisingly high 28 % on “safer than formula milk”, although both formula and water should be of high quality in that country. The UK findings are interesting since, on the one hand, 27 % of women want to start breastfeeding because it is the “most natural
28
7–12 Months (%) 68
93 50 41 81 61 52 80
13–18 Months (%) 60
85 58 53 90 71 40 72
thing to do”, while, on the other hand, 21 % say they do not even want to start at all. This may suggest a potential dilemma in promoting ‘naturalness’ too fiercely, thereby engaging some while dissuading others, and indicates a need to understand both outcomes better to support breastfeeding initiation in the UK more effectively. With regard to reasons for not starting breastfeeding in the UK, perhaps the results from a study in Ireland might be relevant: they included embarrassment at breastfeeding in public, time and lifestyle restrictions associated with breastfeeding, and a negative perception of breastfeeding.31
Duration
In the literature, rates for any breastfeeding at six months in Europe have been reported to be as low as 14 % in Ireland,26 in the Netherlands,32 Finland20
almost 50 % in Italy and Germany,33,34 and as high as 80 % in Norway.21,23
around 30 % 58 % in
In the US, Australia and
Russia, breastfeeding rates at six months average around 45–50 %.35–38 In metropolitan areas of China, breastfeeding rates at four months average around 60–90 %.18 year range from 79–96 %.17,39
In South Asia, breastfeeding rates at one
Our results for the UK at six months (26 %) fall between those reported for Ireland and the Netherlands, and are well below the 50–80 % reported elsewhere in Europe. Our results for China, with 67 % still breastfeeding past six months, appear in agreement with those reported by Xu et al.18
EUROPEAN OBSTETRICS & GYNAECOLOGY SUPPLEMENT 73
18 59
34 36
54 45
72
Our results for India are somewhat lower than
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