What influences the uptake and early cessation of breast feeding?

Objective: to examine obstetric, maternal and social factors associated wit h the uptake and early cessation of breast feeding and women's reasons for altering from breast to bottle feeding. Design: women who responded to a postal questionnaire on long-term postpart um health were contacted and asked to participate in a home-based interview , In addition to health problems, the interview obtained information on bab y feeding and a number of social factors. Women were also asked to complete the Edinburgh Postnatal Depression Scale (EPDS), Obstetric and maternal da ta were obtained from maternity records. Setting: deliveries from a large maternity hospital in Birmingham. Participants: 906 women were interviewed at a mean of 45 weeks after delive ry, Findings: 63% of the women said they had breast fed, but 40% of these stopp ed within three months of delivery, Many of the women gave physical problem s with lactation as reasons for stopping. The factors found to be predictor s of early cessation were: return to work within three months of birth; reg ular childcare support from other female relatives, and a high EPDS score. Non-initiation of breast feeding was predicted by a different set of factor s: multiparity; general anaesthetic (GA); and unmarried status. Discussion and conclusion: despite evidence of the benefits of breast feedi ng, this remains an unacceptable long-term option for many women, and for o ver one-third it is never attempted. Factors within the woman's social envi ronment were found to influence early cessation, Women who had a GA during or immediately following labour and delivery were less likely to initiate b reast feeding, Implications for practice: if breast-feeding incidence and duration are to increase, more attention should be paid to establishing early, successful b reast feeding and countering the negative influences of factors within the social environment.