Mother's intention to breastfeed and awareness of health recommendations

Exclusive breastfeeding to 6 months is recommended by the World Health Organisation (WHO) (1) and also by the Australian Dietary Guidelines for Children and Adolescents (2). While initiation rates of breast feeding are high, few infants are exclusively breastfed to 6 months. A study undertaken in southwest Sydney has looked at mother's awareness of the current health recommendations and how this impacts on their intention to breastfeed exclusively for 6 months (3).

The study was part of the Healthy Beginnings Trial, an early childhood obesity intervention program. South western Sydney is culturally diverse and the most socially and economically disadvantaged area in Sydney.

First time mothers aged over 16 years, 24-34 weeks pregnant, who spoke english, lived locally and who attended the antenatal clinics at Liverpool and Campbelltown hospitals were invited to participate in the study. Four hundred and nine mothers took part and were interviewed at home before giving birth about their awareness of the WHO recommendations and whether they intended to breast feed for the recommended period of time.

61% of mothers were aware of the recommendation to exclusively breastfeed for 6 months but only 42% intended to meet the recommendation. However, 94% intended to initiate breastfeeding. Of the mothers who were aware of the recommendation, 61% intended to meet it compared to 11% of mothers who were unaware of the recommendation.

Mothers level of education was directly related to their awareness of the recommendation with those having a tertiary education being the most aware.  Mother's reasons for intending to breast feed included its good for baby's and mothers health, cost effective, convenient, good for bonding and is natural while those not intending to breast feed cited going back to work/no time, health concerns ( mum has infection), uncomfortable, embarrassing, more convenient to bottle feed or just don't want to breast feed.

Focussing on mothers intention to breastfeed may be an important strategy to increase breastfeeding rates and duration. The study shows that breastfeeding rates could be increased by:- improving mother's knowledge of breast feeding recommendations; addressing negative feelings they have about breast feeding; targeting the less educated and unemployed to improve perceptions and change social norms; and having appropriate government ( longer paid maternity leave)  and workplace policies in place so exlcusive breastfeeding to 6 months is easier to achieve.

Reference.

1. World Health Organisation. Global Strategy for Infant and Young Child Feeding. Report by Secretariat, April 2002, Geneval Switzerland

2. National Health and Medical Research Council. Dietary Guidelines for Children and Adolescents. Commonwealth of Australia 2003

3. Wen ML, Baur LA et al. Intention to breastfeed and awareness of health recommendations:findings from first-time mothers in southwest Sydney, Australia. International Journal of Breastfeeding 2009,4:9 doi:10.1186/1746-4358-4-9 www.internationalbreastfeedingjournal.com/content/4/1/9