Impact of prior birth experiences on current breastfeeding intention and practice

Background: The American Academy of Pediatrics guidelines state a recommendation of “exclusive breastfeeding for about 6 months.” National estimates of breastfeeding rates find comparable rates between first born and non first born infants, however less research has examined intention, initiation and continuance of breastfeeding as family sizes increase. This presentation aims to assess how parity (p) and prior birth experiences influence new mothers’ intention and practice in breastfeeding.

Methods: Data from the 2013 Listening to Mothers III initial (n=2400) and postpartum (n=1072) surveys were used. Analysis of open and closed ended survey responses was conducted to evaluate and compare commonly cited reasons for discontinuation of breastfeeding among primiparous and multiparous mothers.

Results: The proportion of mothers who intended to exclusively breastfeed at the end of their pregnancy decreased from 47% in primiparous mothers to 37% (p=2), 21% (p=3) and 9% (p=4), with comparable reported declines in exclusive breastfeeding at one week. Mothers with a cesarean birth were slightly more likely to report difficulty in getting breastfeeding going, but rates of decline were comparable among mothers with prior vaginal or cesarean births. Mothers who breastfed in an earlier birth and not in the most recent one cited difficulty in getting started, convenience of formula, and work demands as reasons for not breastfeeding again.

Conclusion: Retrospective analysis of mothers’ intention to breastfeed across multiple births found a declining interest in breastfeeding as parity increases with a combination of biological and employment challenges contributing to the change.