Association of family and healthcare provider opinion with a mother's decision not to breastfeed — Infant Feeding Practices II Study

Background: Many mothers in the US choose not to initiate breastfeeding. This study examines maternal perceptions of family members' and clinicians' opinion of how the newborn infant should be fed as factors related to mother's decision not to breastfeed. Methods: The Infant Feeding Practices II study followed mothers from the last trimester of pregnancy until 12 months after birth. During the prenatal survey, mothers indicated their family members' and clinicians' preference for how the newborn should be fed: breastfeeding only, formula only, breastfeeding and formula, or no opinion/don't know. At about 4 weeks postpartum, mothers were asked if they ever tried to breastfeed in the hospital or at home (N=2306). We used logistic regression to examine the association between mothers' perception of family members' and clinicians' feeding preference and the likelihood of not initiating breastfeeding, adjusting for sociodemographic characteristics. Results: Nearly 12% of mothers did not initiate breastfeeding. Not breastfeeding was positively associated with mother's perception that her doctor (AOR=2.42 and 2.14, P<0.01) and the infant's father (AOR=4.23 and 11.12, P<0.0001) favored formula use or had no opinion/didn't know, respectively. Not breastfeeding was also positively associated with the perception that the maternal grandmother (AOR=2.84, P<0.0001) had no infant feeding preference. Discussion: Findings suggest that prior to the infant's birth, mother's belief that her doctor or the infant's father have no opinion on how she feeds her infant may be as important as believing these individuals have a preference for formula use in her decision not to initiate breastfeeding.