SUNDAY, Dec. 27 (HealthDay News) -- Though a growing percentage of American moms start their infants on human milk, relatively few continue breast-feeding for the baby's first six months of life, let alone an entire year.
Why not stick it out longer? Numerous obstacles can prove difficult for new moms, but California researchers say they found that returning to work soon after giving birth presents a major barrier to successful breast-feeding.
"What we saw is if women take very short maternity leaves, of six weeks or less, they run more than a three times higher risk of quitting breast-feeding compared to those still at home who haven't returned to work," said Sylvia Guendelman, a professor who chairs the maternal and child health program at the University of California, Berkeley, School of Public Health.
Their study, published earlier this year in Pediatrics, was part of a larger analysis called "Juggling Work and Life During Pregnancy," funded by the U.S. government's Maternal and Child Health Bureau.
The American Academy of Pediatrics recommends that women breast-feed exclusively for six months and continue breast-feeding for at least an infant's first year of life. Exclusive breast-feeding -- meaning no water, juice, formula or foods -- has been shown to improve protection against many diseases, including bacterial meningitis, diarrhea and ear infections, the academy says.
In the first half of the decade, the number of breast-fed infants increased somewhat, from 71 percent in 2000 to 74 percent by the end of 2006, according to a report from the U.S. Centers for Disease Control and Prevention.
But those figures doesn't tell the whole story.
"Initiation of breast-feeding, although it is one measure, doesn't mean much," Guendelman said. "You can put your baby to the breast for two times and say, 'Well, I tried it and I didn't like it,' or, 'I didn't succeed,'" she said. "But what you really want to look at is, of women who initiate, how many breast-fed successfully for at least six months?"
On that score, the United States has made little progress. Of infants born in 2006, 43 percent were breast-feeding at 6 months and 23 percent at 12 months. Just 14 percent, however, had been exclusively breast-fed for six months.
The numbers fall short of national objectives for breast-feeding. Healthy People 2010, the government's health promotion and disease prevention agenda, seeks to boost the number of breast-feeding women to 75 percent by 2010. The six-month and one-year targets are 50 percent and 25 percent, respectively.
Unlike other industrialized counties, the United States does not have a national maternity leave policy.
To find out whether maternity leave makes a difference for breast-feeding success, Guendelman and her team examined data from 770 full-time working women in Southern California.
Full-time workers with short postpartum maternity leaves were more likely to quit breast-feeding early. Those at highest risk were women in non-managerial and inflexible positions and women with higher stress levels.
Women who had access to workplace benefits such as paid maternity leave or a private office might have greater success, noted Chris Mulford, a retired lactation consultant in Delaware County, Pennsylvania, and member of the U.S. Breastfeeding Committee, a nonprofit group. "They're usually more able to sustain breast-feeding as they return to work than women who work without their own office, without a place at the job where they can express their milk," she said.
Laws related to breast-feeding in the workplace are in place in 24 states, the District of Columbia and Puerto Rico, according to the National Conference of State Legislatures. An Oregon law, for example, allows women to take a 30-minute, unpaid break during each four-hour shift to breast-feed or pump. Oregon has the highest rate of breast-feeding at 12 months, at 37 percent, and the second-highest rate of breast-feeding at six months, at 63 percent, after Utah, where the rate is 69.5 percent, according to the CDC.
All things considered, though, working moms might have a tougher time with breast-feeding than women who are able to take more time with their infants, said Kay Hoover, a lactation consultant at a Philadelphia-area hospital. "If you're separated from your baby, it's hard to maintain milk production," she said.
Guendelman said she would like physicians to advocate for extended postpartum maternity leaves for working women. "If you know you have some time off," she said, "you are more likely to establish breast-feeding in the first 30 days and not just give up so quickly."
The National Women's Health Information Center has more on breast-feeding.
SOURCES: Sylvia Guendelman, Ph.D., chairwoman, maternal and child health program, and professor, community health and urban development, School of Public Health, University of California, Berkeley; Chris Mulford, B.S.N., I.B.C.L.C., retired lactation consultant, Delaware County, Pa., member, U.S. Breastfeeding Committee, and co-chairman, Business Case for Breastfeeding project, Pennsylvania Breastfeeding Coalition; Kay Hoover, M.Ed., I.B.C.L.C., lactation consultant, Philadelphia; U.S. Centers for Disease Control and Prevention, Atlanta (www.cdc.gov); National Conference of State Legislatures, Denver; University of California, news release, Jan 5, 2009; February 2005, Pediatrics; January 2009, Pediatrics