Tuesday, September 11, 2007

Breastfeeding Intentions

Public health officials have repeatedly announced their intention in recent years to increase the number of mothers who initiate breastfeeding of their babies and to increase the number of mothers who breastfeed their babies for at least six months. These intentions have been spelled out in both Healthy People 2000 and Healthy People 2010, where public health officials have expressed their hope of raising to 75% the percentage of infants breastfed during the first weeks of life and to 50% the percentage of infants breastfed for at least six months. Unfortunately, these officials have not been able to fulfill their intentions, largely — it appears — because the intentions of individual American mothers do not line up with those of public health officials.

The role of mothers’ prenatal intentions in determining actual breastfeeding behavior comes in for careful scrutiny in a study recently published by health researchers at Emory University, the Food and Drug Administration, and the Centers for Disease Control and Prevention. Not surprisingly, their findings highlight the importance of “the need to continue efforts to understand what influences prenatal breastfeeding intentions, because this is an important predictor of a mother’s behavior after delivery.” The researchers’ data — drawn from 625 women who continued to breastfeed for at least 20 weeks and from 636 women who started breastfeeding but who continued for less than 20 weeks — indicates that employment intentions loom extremely large in shaping breastfeeding behavior.

Almost half (49%) of women who had “no intention to return to work” were still breastfeeding 20 weeks after delivery, compared to less than 20% of those who intended to return to work part-time after six weeks — and lower percentages for those who intended to return to work full-time after six weeks or who intended to return to full-time or part-time work in less than six weeks.

The authors of the new study acknowledge “the benefits of breastfeeding for both infants and mothers,” noting that “breastfeeding provides optimal nutrients for infant growth and development, enhances infants’ immunologic defenses, and facilitates mothers’ recovery from childbirth.” The researchers even acknowledge that “breastfeeding also provides significant social and economic benefits to both the individuals involved and the nation as a whole,” as it makes possible “reduced health care costs” and “increased time available to the parent for the child’s siblings and family responsibilities because the infant is healthy.” But relatively few will realize these very real benefits of breastfeeding so long as even those who recognize them refuse to call for a reduction in the maternal employment that puts babies on the formula-filled bottle.

(Source: Ann DeGirolamo et al., “Intention or Experience? Predictors of Continued Breastfeeding,” Health Education & Behavior 32 [2005]: 208-226.)

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