Which Australian Women Do Not Exclusively Breastfeed to 6 Months, and why?

Abstract

Background Rates of exclusive breastfeeding in Australia lag behind international targets. Reasons for non-exclusive breastfeeding are poorly understood. Research aims To describe demographic profiles of participants reporting different feeding practices, and reasons for not exclusively breastfeeding to 6 months. Methods Demographics for 2888 mothers (5340 children) and reasons for 1879 mothers (3018 children) from the Mothers and Their Children’s Health Study (a sub-study of the Australian Longitudinal Study on Women’s Health) were examined using descriptive statistics and multivariable regression. Results Only 34.4% of children were exclusively breastfed to 6 months. Five non-exclusive feeding practices were identified: never breastfed (3.9%), breastfed < 6 months (20.8%), and breastfed to 6 months but had formula (6.8%), solids (24.5%), or both formula and solids (9.7%). Mothers of children who received < 6 months of human milk were more likely to have a lower education, be overweight/obese, smoke, and live in cities (compared to mothers of children exclusively breastfed). Reasons for never breastfeeding and for breastfeeding < 6 months were primarily insufficient milk and breastfeeding difficulties (e.g., latching issues). Reasons for introducing solids were primarily cues for solids (e.g., showing interest). Reasons for formula were insufficient milk and practical considerations (e.g., return to work). Reasons for both solids and formula were diverse, including insufficient milk, weaning cues, and practical considerations. Conclusions Mothers who did not exclusively breastfeed to 6 months were a heterogeneous group, indicating that both targeted and universal strategies are required to increase rates of exclusive breastfeeding. Support should encompass the broad range of feeding practices.

The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply

“…This occurs for a multitude of reasons, reflecting breastfeeding difficulties and insufficient access to lactation support and postnatal care, as well as broader family and social support, access to paid maternity leave and social and cultural norms about infant feeding [3]. For some women, ceasing breastfeeding earlier than initially desired leaves them feeling stigmatised [4] and can be a source of shame, grief, guilt, distress and anxiety [5,6], contributing to a reduced sense of agency to achieve breastfeeding goals and poor psychological wellbeing [7,8] One of the most common reasons cited for early cessation of breastfeeding is perceived low or insufficient milk supply [9][10][11][12]. This should be managed initially by the provision of breastfeeding counselling and support [13], however, when concerns persist, substances known as galactagogues are often recommended [13,14].…”

Associations between feeding practices in infancy and fruit and vegetable consumption in childhood

“…This is probably due to the high proportion of mothers in our study with a university education (65•6 %), which may affect the generalisability of the findings. Duration of breast-feeding and first complementary food were retrospectively recalled; however, our previous work has found that breast-feeding to 6 months was recalled with more than 90 % accuracy when comparing measures in MatCH with measures in ALSWH, which were completed within 3 years of the child's birth (26) . First complementary food was not asked in ALSWH so we were unable to cross-check this variable; however, we did include a 'Can't remember' option in the list of potential first foods, and children where this option was selected were not included in the analysis.…”

“…Longer duration of any or exclusive breast-feeding is associated with higher fruit and vegetable intake in childhood (19)(20)(21)(22)(23) , although associations with fruit intake are less consistent (19,24,25) . However, there is a great deal of variation in breast-feeding practices during the first 6 months, with some mothers exclusively breast-feeding, some supplementing with formula and/or complementary foods and some breast-feeding for less than 6 months or not at all (26) . Due to the focus in research on exclusive breast-feeding (20,23,25) , or failure to report on exclusive and mixed breast-feeding separately (19,22) , there is little information about whether these varying breast-feeding practices are associated with fruit and vegetable consumption in childhood.…”

“It Is a Very Emotional Topic for Me”—Managing Breastfeeding Problems among German Mothers: A Qualitative Approach

“…Rated as less important reasons are social ones, for instance, resuming work after maternity leave. Besides that, studies from other countries show that many women face problems when starting breastfeeding, resulting in early cessation of breastfeeding [17][18][19]. However, little is known about how women who are unable to breastfeed or are faced with breastfeeding problems perceive this situation.…”