Pediatricians agree exclusive breastfeeding for the first six months of life provides a wealth of benefits to a mother and child. But new research from the School of Public Health at the University of Minnesota finds one-third of women enter pregnancy in poorer health, and are less likely to plan to breastfeed and less successful at exclusive breastfeeding when they do plan to breastfeed their babies. The study found women who are obese, have diabetes or have hypertension were 30 percent less likely to intend to breastfeed than mothers without health complications.

The study findings were published today in PLOS ONE.

“Statistically we’re seeing an increase in breastfeeding in the U.S., which is great news. Unfortunately, at the same time, rates of obesity and other health problems are increasing. More than a million women each year enter pregnancy with a health problem, and our study shows that these mothers were less likely to plan to breastfeed,” said Katy Kozhimannil, Ph.D., lead author of the study and assistant professor in the in the School of Public Health at the University of Minnesota. “This is troubling because the families with social and medical risk factors are often those who stand to gain the most benefits from breastfeeding.”

This study used data from Listening to Mothers III, a national survey of 2,400 women who gave birth to a single baby in a U.S. hospital between 2011 and 2012. Women reported information about their childbirth experience, including their health conditions, breastfeeding intentions and breastfeeding practices in the first week after their baby was born.

Key findings:

• Approximately one-third of U.S. mothers enter pregnancy with one or more of the following major health conditions or risk factors: diabetes, hypertension or obesity.
• Women who entered pregnancy with a health complication were 30 percent less likely to intend to breastfeed their child, compared to mothers with uncomplicated pregnancies.
• Among women who intended to breastfeed exclusively (without any formula use), those with complex pregnancies (involving diabetes, hypertension or obesity) were less likely to fulfill this goal.
• Women with complex pregnancies were less likely to receive recommended hospital-based support.

“It’s important to stress that supportive hospital practices like showing mothers how to breastfeed, rooming-in, refraining from pacifiers and not routinely providing free formula improves breastfeeding rates among new mothers. Nurses, midwives, doulas, doctors and lactation consultants also play a pivotal role in helping women set and achieve their breastfeeding goals,” said Kozhimannil. “Women with medically complex pregnancies may need extra time, support and attention to overcome potential challenges to breastfeeding.”

Kozhimannil reiterates that individual support offered before and after pregnancy is most effective in supporting pregnant women to set and attain breastfeeding goals. Clinicians should also address breastfeeding intentions with patients during prenatal care visits and provide encouragement and support at the time of delivery. In addition, hospitals that serve women with complex pregnancies may consider adopting the breastfeeding practices recommended by the World Health Organization’s Baby Friendly Hospital Initiative.

~ Post by Matt DePoint, Academic Health Center