When Tamara Clarke gave birth to her son in April, she had every intention of exclusively breastfeeding him until he was at least three months old.
But her plans got sidelined when she said hospital staff encouraged Clarke to give her 8-lb son formula after he lost 9 percent of his body within the first three days. She gave in, but soon after, the baby experienced "nipple confusion," and she could not get him to latch while breastfeeding. After he was exclusively fed formula his final day in the hospital, Clarke said she had to pump then feed her son through a bottle when they returned home.
"Around four weeks of age, he started latching on again and now he feeds from the breast like a pro," said Clarke of Marietta, Ga. "It was an uphill battle getting back there. I still pump and bottle feed him breast milk as well as supplement with formula at night. Although, he's getting my breast milk now, I still look back on that experience and feel duped."
Like Clarke, most new moms hope to exclusively breastfeed their babies for at least the first three months, but a new study from the Centers for Disease Control and Prevention found that, for a variety of reasons, only about one-third of those moms fulfill that breastfeeding goal.
CDC researchers surveyed nearly 1500 pregnant women on their plans for exclusive breastfeeding after their babies were born, and then followed up with monthly surveys throughout the next year. The scientists found that 85 percent of mothers planned to breastfeed exclusively for at least three months, but only about 32 percent were able to do so for the intended amount of time.
"While most of these women said they hoped to exclusively breastfeed for at least three months, very few actually succeeded in their goal," said Cria Perrine, co-author of the study and an epidemiologist in the division of nutrition, physical activity and obesity at the CDC. "There is obviously a huge disconnect between these women's intentions and how they're able to follow through."
Perrine said many hospitals might not be as supportive as possible in helping women achieve these goals. In the study, 15 percent of the women's babies had already been given some sort of supplement to their breast milk before even leaving the hospital, which can cause nipple confusion and make it difficult to breastfeed afterwards.
Moms who began breastfeeding within an hour of birth were more likely to breastfeed according to their goals. Those who already had at least one other child and those whose babies were not given supplemental formula feedings were also more likely to reach their exclusive breastfeeding goals.
Women who were obese, smoked or had a longer intended exclusive feed time were less likely to reach their goals, the researchers found.
The study authors concluded that increasing Baby-Friendly Hospital practices, which include giving only breast milk to babies in the hospital, might help mothers reach their breastfeeding goals.
"We now have the evidence to prove that giving anything other than the breast to a newborn is the key factor in the success of the breastfeeding relationship," said Emma Kwasnica, a Vancouver-based childbirth and breastfeeding educator. "Even more appalling is the fact this disruption happens during the very first two days of life. When 80 percent of hospitals in the USA are supplementing the newborn baby by Day 1 or 2, the mother-baby unit doesn't even stand a chance."
The Baby-Friendly Hospital Initiative is a global program sponsored by the WHO and UNICEF. Its mission is to encourage hospitals to offer an optimal level of care for infant feeding by giving mothers information, confidence and skills to successfully initiative and continue breastfeeding their babies.
The initiative also hopes "to end the practice of distribution of free and low-cost supplies of breast-milk substitutes to maternity wards and hospitals."
"This isn't a lofty goal and it must be achieved in order to reverse the rates of breastfeeding sabotage that we are now clearly seeing," said Kwasnica. "Adding further insult to injury is the deplorable lack of paid maternity leave in the USA. It is no wonder that so few mothers are still breastfeeding by 8 weeks, as they are already back at work."
But the breastfeeding relationship has already been jeopardized when supplements are given in the hospital. Nevertheless, women who experience problems need more than just baby-friendly hospitals," said Susan Burger, president of the New York Lactation Consultant Association.
"They need customized follow-up care to assist them to overcome their own specific problems to augment the general advice they may receive in the few short days they are in the hospital," Burger said.