Study Investigates Women's Feelings About Early Breastfeeding Cessation

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Women who stop breastfeeding their infants within 2 weeks after birth report a range of problems, states a qualitative study published in the current issue of the American Journal of Maternal and Child Nursing. According to the authors, these problems can be addressed through changes in clinical practice.

The study's objective was to learn about these women's "subjective experience" in order to supplement the literature demonstrating that many women breastfeed their infants for only short periods. The authors recorded and evaluated the descriptions of efforts to breastfeed from 9 women between the ages of 20 and 32.

The difficulties and problems reported by the women in this study included 1) disparity between expectations that breastfeeding would be easy or come naturally and "the reality of their early breastfeeding experience"; 2) feelings of discomfort either with breastfeeding or with the assistance provided by nurses and lactation consultants; and 3) feelings of guilt, shame, and stress associated with discontinuing breastfeeding.

In response to feelings and concerns reported by these women, the authors encourage health professionals to:

1. Provide prenatal and postnatal education to women who intend to breastfeed, particularly about common breastfeeding problems;



2. Be sensitive to emotional distress and in responding to requests for assistance with breastfeeding;



3. Use infant formula "only when medically indicated";



4. "Respect women's personal boundaries and ask permission before touching the breasts"; and



5. Ensure that all nursing staff "offer consistent, evidence-based advice about breastfeeding techniques."

The authors conclude, "Nurses in maternal child care have an obligation to develop skills such as calming techniques, ways to wake sleepy babies, methods to encourage latching on, and how to perform an assessment of positioning, grasp, and suck at the breast.... However, when 'it just doesn't work,' and the decision is made to stop breastfeeding, mothers should be reassured that bonding, attachment, and infant health are not irreversibly damaged and that the quality of their mothering is not somehow linked incontrovertibly to the feeding method chosen. The anger, guilt, and lingering self-doubts reported by our mothers should not be an outcome of our efforts to promote breastfeeding."

Mozingo JN et al. 2000. "It wasn't working": Women's experiences with short-term breastfeeding. Journal of Maternal and Child Nursing 25(3):120-126.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.