The majority of mothers intend to breastfeed at birth. Many factors can disrupt this intent. Research done in the U.S. in 2012 shows that information about breastfeeding is rarely provided by a women’s obstetricians during their prenatal visits and some obstetricians incorrectly believe that due to recent improvements commercially prepared formula is equal to breast milk in terms of its health benefits. Many hospitals have instituted practices that encourage breastfeeding, however a 2012 survey in the U.S. found that 24% of maternity services were still providing supplements of commercial infant formula as a general practice in the first 48 hours after birth. The Surgeon General’s Call to Action to Support Breastfeeding attempts to educate practitioners
Work is the most common cited reason for not breastfeeding. In 2012 Save the Children examined maternity leave laws, ranking 36 industrialized countries according to their support for breastfeeding. Norway ranked first, while the United States came in last. Maternity leave in the US varies widely, including by state, despite the Family Medical Leave Act (FMLA), which guarantees most mothers up to 12 weeks unpaid leave. The majority of US mothers resume work earlier.
- Mother – Adolescence is a risk factor for low breastfeeding rates, although classes, books and personal counseling (professional or lay) can help compensate. Some women fear that breastfeeding will negatively impact the look of their breasts.However, a 2008 study found that breastfeeding had no effect on a woman’s breasts, other factors did contribute to “drooping” of the breasts, such as advanced age, number of pregnancies and smoking behavior.
- Partner – Partners may lack knowledge of breastfeeding and their role in the practice.
A number of hospital-employed procedures have been found to interfere with breastfeeding, including routine mother/baby separation, delayed initiation, vigorous routine suctioning, medications and mode of delivery.
Pain caused from mis-positioning the baby on the breast or a tongue-tie in the infant can cause pain in the mother and discourage her. These problems are generally easy to correct (by re-positioning or clipping the tongue-tie).
Breast surgery, including breast implants or breast reduction surgery, reduces the chances that a woman will have sufficient milk to breastfeed. Women whose pregnancies are unintended are less likely to breast feed their babies
The central concern about breastfeeding in the presence of maternal HIV is risks of the child becoming infected. Factors such as the viral load in the mother’s milk complicate breastfeeding recommendations for HIV-positive mothers
Breastfeeding mothers should inform their healthcare provider about all of the medications they are taking, including herbal products. Nursing mothers can safely take many over-the-counter drugs and prescription drugs and receive immunizations, but certain drugs, including painkillers and psychiatric drugs, may pose a risk.
The U.S. National Library of Medicine publishes “LactMed”, an up-to-date online database of information on drugs and lactation. Geared to both healthcare practitioners and nursing mothers, LactMed contains over 450 drug records with information such as potential drug effects and alternate drugs to consider
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