The Reasons for Early Weaning, Perceived Insufficient Breast Milk, and Maternal Dissatisfaction: Comparative Studies in Two Belgian Regions

Abstract

Objective and Method. To report on the weaning reasons at the maternity ward, at 3, 6, and 12 months and to report the socioeconomic characteristics of mothers not satisfied with breastfeeding duration as well as of those who have weaned their child because of perceived insufficient milk (PIM). Two cross-sectional studies were performed in 2012. Results. 62.9% of mothers in Wallonia and 56.8% in Brussels are dissatisfied with the duration of breastfeeding. In the two regions, younger mothers, ignoring the WHO recommendations, having a low level of education, or thinking not having sufficient milk production, were more likely to be dissatisfied. According to the analysed period, PIM and return to work are the two leading causes of weaning. While in Brussels PIM seemed to be associated only with partial BF at the maternity ward, in Wallonia, PIM was associated with a less educated environment and with ignoring the WHO recommendations. Conclusions. Too many mothers, especially destitute, are dissatisfied. They more often evoke PIM as reason for weaning. However, the literature shows that the real lack of milk only affects 1–5% of the mothers. Professionals need to be better informed of this discrepancy between mothers' perception and physiology. They should be more supportive, especially among more precarious mothers.

A comparison of exclusive breastfeeding in Belgian maternity facilities with and without Baby‐friendly Hospital status

“…In the Wallonian context, little adequate BF support exists (except for lactation consultants or limited advice available by phone). In an earlier study, we observed that perceived milk insufficiency, breast engorgement, and cracked nipples accounted for more than 45% of reasons for weaning during the first 3 months (Robert, Coppieters, Swennen, & Dramaix, , ). These issues do require trained personnel, which is scarce in Belgium, (Benahmed, ), as in other countries (Morris, ; Pound, Williams, Grenon, Aglipay, & Plint, ; Sims, Long, Tender, & Young, ).…”

Response to Ward et al. re: “ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017”

“…22,23 Early management of the new breastfeeding mother Some breastfeeding mothers question the adequacy of colostrum feedings and perceive that they have an insufficient milk supply. 24,25 These women may receive conflicting advice about the need for supplementation and would benefit from reassurance, assistance with breastfeeding technique, and education about the normal physiology of breastfeeding and infant behavior. Inappropriate supplementation may undermine a mother's confidence in her ability to meet her infant's nutritional needs 26 and give inappropriate messages that may result in supplementation of breastfed infants at home.…”

Young children in Brussels: from an institutional approach to a systemic view

“…Only two of them -breastfeeding and vaccination coverage -are measured for young children. According to the 2012 PROVAC survey, 80.9% of mothers breastfeed exclusively when they leave the maternity hospital, with an average duration (exclusive or not) of six months in Brussels [Robert et al, 2014b]. It is slightly higher in the municipalities with a low socioeconomic level, due to the presence of non-Belgian populations where breastfeeding is more common [OSS, 2013b].…”