Reluctance to continue breastfeeding in The Netherlands

A prospective cohort study of breastfeeding practice (0-4 mo) was carried o ut in well-baby clinics. The cohort included 4438 newborns brought to a cli nic for the first time between I April and I July 1998. The odds ratios of demographic and gestational variables connected with the start and duration of breastfeeding were measured. The frequency of the reasons why breastfee ding was interrupted was determined. At birth 71% of the infants included i n this study were exclusively breastfed. After 4 mo the percentage had drop ped to 21%. Breast milk was replaced directly by formula (23%) or by a mixt ure of breast milk and formula (77%). Exclusive breastfeeding was given irr espective of the mother's cultural background. Higher education appeared to be the most decisive factor for the initiation of exclusive breastfeeding; higher parity was found to be the most decisive factor for continuation. I n 46% of cases the infant's health and behaviour caused mothers to stop exc lusive breastfeeding; in 38% the reasons were mother related; in 17% both m other- and infant-related motives were mentioned. Conclusion: Mothers' perception of hunger and crying colics were the main i nfant-related reasons for cessation of breastfeeding, whereas physical prob lems, return to work, doubt about the sufficiency of breast milk and the fe eling of being restricted by breastfeeding were the main mother-related rea sons. The decision to abandon exclusive breastfeeding was made primarily by mothers (71%). In The Netherlands more babies are breastfed at birth than was the case 10 y ago, but the duration of the breastfeeding period has bec ome shorter.