As a Certified Breastfeeding Counselor (CBC) you should be aware of current breastfeeding recommendations. However, despite these recommendations, many parents are not reaching personal or public health breastfeeding goals. Early weaning can be problematic for a mother baby pair not desiring to wean, and a public health issue.
To find out why early weaning occurs, a systematic review was done and published. Researchers Elisabeth Mangrio RN, PhD; Karin Persson RN, PhD; and Ann-Cathrine Bramhagen RN, PhD, reviewed information from four databases.
They wanted to, “compile evidence regarding sociodemographic, physical, mental and social factors that influence breastfeeding mothers to stop breastfeeding before the infant reaches 6 months.”
Why Is Early Weaning Problematic?
Leading health organizations, such as the World Health Organization (WHO) and The American Academy of Pediatrics (AAP) recommend exclusively breastfeeding at least 6 months. Then continuing breastfeeding a minimum of 1 year (AAP) or 2 years (WHO) alongside solids and continuing as long after as both parties desire.
Breastfeeding rates are a public health issue because on a population level breastfeeding:
- Reduces the risk of postpartum hemorrhage
- Reduces maternal risk of certain cancers such as breast, uterine, etc.
- Provides infants with protection against illness by reducing frequency, duration, and severity of common childhood illnesses
- Impacts a child’s metabolism both short and long-term reducing the risk of obesity, diabetes, etc.
- Lowers overall healthcare costs by reducing hospitalization rates
- Saves approximately 800,000 lives globally per year according to the WHO
As you can see, breastfeeding is a major public health issue. As a CBC, your work can truly impact and even save lives.
That said, on an individual level, there are many factors which influence breastfeeding duration. In some situations, breastfeeding is not the best arrangement for a mother baby dyad. This can be for many reasons and as a CBC, our job is to encourage, support and educate families to make the decisions right for them.
However, understanding the importance of breastfeeding from a public health perspective helps us support the most clients in the best way. It also provides us with understanding of how we can best support and prevent parents from prematurely weaning.
Study authors concluded, “The preventive work should focus on how to improve the knowledge of healthcare professionals and targeted interventions must address mothers who are at risk of ceasing breastfeeding before the recommended time.”
What Factors Influenced Early Weaning?
Despite recommendations, many infants are weaned prematurely. As a CBC, it is important to be aware of the variety of factors. This systematic review found four (of likely many) contributing factors on a population level.
This means that in a large group, we see these as common factors in reduced breastfeeding rates and duration. This does not mean all individuals with these common factors wean prematurely or even struggle with breastfeeding.
Younger Maternal Age Was Associated With Earlier Weaning
If you are thinking, “I was a young mother and I breastfed until my child was three!” or “My younger clients breastfeed for a long time,” then you are focused on individual and not population level. Remember, we are looking at factors we see in large populations.
Some reasons we may see earlier weaning in younger mothers include:
- Inconsistent breastfeeding support
- Lack of respectful support could be off-putting
- Breastfeeding is not the cultural norm everywhere
- Inadequate information and education about breastfeeding provided during prenatal care
- The influence of social support. If one’s social network is unfamiliar with or unsupportive of breastfeeding this can impact breastfeeding rates and duration
Cesarean Birth And Earlier Weaning
Many mothers breastfeed after a c-section. Having a c-section birth does not mean breastfeeding will always be more challenging. Nor does it mean if challenges occur they cannot be overcome.
That said, it is not uncommon to have a delay in full milk supply after a c-section. Afterall, we are asking the body to heal from pregnancy, major surgery, and then also produce milk. It absolutely can, but it is asking a lot of women and their bodies.
On a population level, we see an association between c-section birth and early weaning.
Returning to Work Before 12 Weeks Postpartum
In the US, one small study found nearly 1 in 4 mothers returned to work or school within 2 weeks of giving birth. Establishing a healthy breastfeeding relationship takes time. Pumping can be quite challenging even with the most supportive workplace and home life.
Factor in variables for poor work support or demanding home responsibilities, and it is not surprising an early return reduces breastfeeding duration.
Low Milk Supply
For mothers with true low milk supply, breastfeeding often requires pumping, frequent feeds, and supplementing. While many cases of low milk supply can be remedied, some struggle with low supply the duration of feeding.
Given the amount of time needed to navigate low supply, it is very understandable we see shorter feeding duration.
As a CBC, knowing the above factors in early cessation can help you support at-risk clients. Early prenatal education and ongoing early feeding support are vital for helping parents meet their breastfeeding goals.