Initial steps crucial to breast-feeding success

Planning to exclusively breast-feed?

Start right after giving birth, feed on demand, keep the baby in your hospital room to sleep and ask the staff for support.

Such “Baby-Friendly” steps make it more likely a new mom will stick to her breast-feeding goal, says a new report from the U.S. Centers for Disease Control and Prevention.

Published in Pediatrics, the study found that women struggle to breast-feed as long as they had intended. More than 1,200 mothers who aimed to exclusively breast-feed for three months or more were surveyed from 2005 to 2007.

More than 67 percent didn’t make it. And 15 percent of those mothers gave up on their goal within a week of leaving the hospital.

Researchers examined whether it made a difference when mothers were exposed to the 10 practices recommended by the Baby-Friendly Hospital Initiative, promoted by the World Health Organization and the United Nations Children’s Fund.

Requirements for Baby-Friendly status include policies that encourage babies “rooming-in” with mothers and discourage using formula unless medically directed.

Mothers who experienced six of the recommended practices had 2.7 times the odds of achieving their goal, compared to women exposed to zero or one.

“One of the most important facts is keeping the baby and mother together,” said Karen Buchi, the University of Utah Hospital’s Well Baby Nursery co-medical director. “Most of our healthy babies never actually have to leave their mother’s side.”

Annette Clark, 33, recently gave birth at University Hospital. She and her husband, Ken, are planning for their new daughter, Riley, to be breast-fed for at least six months.

“I’m going back to work (in 10 weeks), but the longer you can breast-feed is the goal,” she said.

Nurses helped her start breast-feeding in the hour after Riley, her first child, was born and continually asked how it was going, Annette Clark said.

That support “is really important; the nurses here are fantastic,” she said. “Without that, I’m not sure it would’ve been as easy to get started.”

The first days of breast-feeding are the most trying time for mothers, Buchi said. In the past, when frustrations arose, formula was at hand.

It was provided free to parents and was sometimes given to calm a crying baby, she said. After baths, a bottle would be placed in a baby’s bed “just in case they needed it,” Buchi said.

Such “non-breast-milk feedings” were the primary hospital practice associated with women not achieving their exclusive breast-feeding goal, the CDC said.

“Despite all of the mothers in this analysis intending to exclusively breast-feed, 40 percent reported that their infant received supplemental feedings in the hospital,” the study said.

Delays before a mother begins to produce breast milk, less effective instruction from hospitals and perceived problems with breast-feeding during the hospital stay also contributed to women stopping sooner than they intended, the study said.

The American Academy of Pediatrics, which publishes Pediatrics, recommends that mothers breast-feed exclusively for at least six months. Its studies show that breast milk has all the essential nutrients, calories and fluids a baby needs to be healthy, including antibodies to help prevent infections. However, commercial infant formulas are a nutritious alternative, it notes.

What is most important, according to Buchi and the AAP, is feeding newborns in their first hours and days with their mother’s colostrum, which forms late in pregnancy and appears before breast milk. It’s high in protein and low in fat.