The World Health Organization (WHO) and the American Academy of Pediatrics take the view that around six months of breast feeding is a target bench mark, meaning only breast milk and medications or micronutrient supplements, but no other liquids or solids. Surveys have shown that few mothers achieve this goal in the US, but it was not specifically known whether this was by accident or design.
Centers for Disease Control and Prevention conducted a survey of pregnant women about their intentions for exclusive breast-feeding and published their results under the title:"Baby-Friendly Hospital Practices and Meeting Exclusive Breastfeeding Intention."
They discovered that although 85% of mothers planned to breast feed for at least three months, less than a third managed to meet their own goal. Those who already had a baby and were married seem to have better chances. Breast feeding within an hour of birth was also seen as an important factor in developing the mother-baby breast feeding regime. On the flip side, those who were obese, were smokers or set themselves longer goals for breast feeding, stood less chance of achieving their target.
In addition, the report shows that when hospitals give out infant formula and or pacifiers, the mothers chances are reduced, presumably because she more easily turns towards the alternatives. The study suggests that increasing "Baby-Friendly Hospital Practices", particularly by supporting mothers to breast feed exclusively while in hospital, will assist more mothers in meeting their goals.
Previous research has shown that babies fed on infant formula from a younger age tend to have more health issues in later life. The research was contested by some, who suggested that babies fed on infant formula immediately or in the first few months after birth, were likely to have many other issues, including unprivileged mothers, working mothers, or those with unhealthy lifestyles. Thus, babies that were not breast fed for as long, if at all, were simply markers for other social issues in their upbringing that might affect their health.
There has been a drive in the UK in recent years to educate and push more mothers to breast feed for longer, however, an article from University of Aberdeen and the University of Stirling, published in the BMJ, was highlighted in March of this year by the Gurdian Newspaper and cause quite an uproar. The Scottish scientists suggested that the six month target from the WHO was overly idealistic, and putting mothers under necessary pressure. Hospital staff were often unavailable to help new mothers and many other practical factors came into play in the months following birth, that they say left the success of hitting the six month goal was largely down to luck.
They state that :
"More achievable incremental goals are recommended. Unanimously, families would prefer the balance to shift away from antenatal theory towards more help immediately after birth and at three to four months, when solids are being considered."
It goes without saying that breastmilk provides babies with essential nutrients and figures are clear that breastfed babies suffer less chance of diarrhoea and vomiting, which can only be good for both mother and baby. The breast fed babies also have fewer chest and ear infections, are less constipated and are less likely to become obese.
The editor-in-chief of BMJ Open, Dr Trish Groves, clarified the article stating: "Any research or other article that seems to be 'anti-breastfeeding' is, rightly, highly controversial. This study is not, however, against breastfeeding: far from it."
The reasons that mothers end up quitting breast feeding seem to come down to a number of factors including:
- Having a difficult start. Mothers are usually tired after giving birth and poor circumstances during the first few days give mothers an understandable reason for giving up. Sore nipples, late nights, and a difficult baby, make it easier to reach for the bottle.
- Baby isn't getting fed enough. It's impossible to tell how much a baby is eating when it's being fed directly from the breast, and this can lead to the worry. Breast fed babies tend to stay at the breast longer, simply because it's relaxing to them, and the human milk is more digestible, so they generally eat more and more often and might appear hungrier. It's easy for a new mother to get nervous and want to start supplementing with a bottle. This of course begins to slow down the breast production and makes continuing breast feeding more difficult.
- Feeling awkward to nurse in public. In our politically correct society, and considering that breasts are considered very sexual, many women just don't feel comfortable exposing themselves in public, and it's hard sit in a rest room or private place for half an hour or more while the baby feeds.
- Needing to go back to work. While some mothers do manage to express milk or nurse their baby while working, the pressures of a modern job don't leave much room for regular feeds. Once the routine is broken, the breasts produce less milk and babies get used to bottle feeding, which quickly leads into using formula when supplies are short.