Effect of differently worded messages about alcohol on intent to breastfeed among university women in South Korea

Abstract

Background: There is concern that advice not to drink alcohol could discourage the initiation and particularly shorten the duration of breastfeeding. However, little research has explored the impact of variously worded messages about drinking while breastfeeding on women’s intentions to drink or to breastfeed. Methods: We haphazardly allocated a convenience sample of nulliparous (>95%) Korean female university students to be exposed to three differently worded messages on alcohol use during breastfeeding in the body of a questionnaire. Translated to English, they were as follows: Liberal: “Breastfeeding is compatible with moderate but not heavy drinking of alcohol.” Moderate: “You can use alcohol while breastfeeding, but only on rare occasions and only 1-2 drinks at a time. Too much alcohol can harm the breastfeeding process. After each drink, you should wait 2 hours before breastfeeding to keep the child from being affected.” Strict: “You should never use alcohol while you are breastfeeding.” Results: Most of the 280 valid responses expressed an intention to breastfeed. Over 90% of sampled women drank alcohol currently; 91% of them intended to reduce consumption during breastfeeding. How strictly messages were worded did not affect intention to drink during breastfeeding. Neither strict nor liberal messages reduced intention to drink alcohol while breastfeeding. The strict message clearly told the students what to do, whereas the moderate and liberal messages left choices up to them. Receiving these messages that required women to decide for themselves reduced the women’s intention to breastfeed (p<0.001). Conclusions: In this sample of largely nulliparous university women, a more strictly worded message regarding alcohol use during breastfeeding did not reduce breastfeeding intentions. Messages that left decisions up to the women did. The risk of harm associated with alcohol consumption during breastfeeding should we weighed against the risk that raising concerns about alcohol consumption might reduce the initiation or duration of breastfeeding. Research is needed to test such messages in different cultures and to follow up after delivery to see if indeed expressed intent correlates with actual practices. Until then, messages regarding breastfeeding and alcohol are likely to continue to be based only on the unexamined assumptions as to whether cautions about alcohol will affect women’s breastfeeding practices.