Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Maternal and Pediatric Nutrition

Why do women stop breast-feeding? Results from a contemporary prospective study in a cohort of Australian women

Abstract

Background/Objectives:

Australian guidelines recommend infants be breast-fed for at least their first year of life; however, for a variety of reasons many mothers cease breast-feeding before this age. The objective of this study was to determine the reasons why women stop breast-feeding their infant completely, in relation to the age of the infant.

Subjects/Methods:

Primiparous Australian women aged between 18 and 40 years underwent a self-administered questionnaire-based birth cohort study on infant-feeding attitudes, behaviours and feeding patterns. Data were extracted from the demographic questionnaire and from questionnaires administered at 2, 4, 6 and 12 months of infant age between October 2010 and September 2011.

Results:

Breast-feeding initiation in this cohort was 97%; however, by 52 weeks of infant age 46% of mothers had completely ceased breast-feeding. In those mothers who had ceased breast-feeding before 26 weeks the most common reason was ‘I did not have enough milk’. In those mothers who had completely stopped breast-feeding between 26 and 52 weeks the most common reason reported as being very important in the decision to cease breast-feeding was ‘My baby lost interest’.

Conclusions:

Maternal concerns regarding breast trauma, milk supply and infant satiety were central mediators of breast-feeding duration among these Queensland women. Further research into the antecedents of sucking pathologies and reasons for nipple trauma is indicated. Health professionals can assist women to recognise cues of hunger and satiety in their infants and understand the dynamics and natural history of breast-feeding to prolong breast-feeding relationships.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. National Health and Medical Research Council Infant Feeding Guidelines. National Health and Medical Research Council: Canberra, 2012.

  2. Labbok MH, Clark D, Goldman AS . Breastfeeding: maintaining an irreplaceable immunological resource. Nat Rev Immunol 2004; 4: 565–572.

    Article  CAS  Google Scholar 

  3. Schack-Nielsen L, Michaelsen KF . Advances in our understanding of the biology of human milk and its effects on the offspring. J Nutr 2007; 137: 503S–510S.

    Article  CAS  Google Scholar 

  4. Horta BL, Bahl R, Martines JC, Victora CG . Evidence on the Long-term Effects of Breastfeeding: Systematic Reviews and Meta-analyses. World Health Organisation: Geneva, 2007.

    Google Scholar 

  5. Chung M, Raman G, Chew P, Magula N, Trikalinos T, Lau J . Breastfeeding and maternal and infant health outcomes in developed countries. Evid Technol Asses (Full Rep) 2007; 153: 1–186.

    Google Scholar 

  6. Kramer MS, Kakuma R . The Optimal Duration of Exclusive Breastfeeding. Springer, 2004.

    Book  Google Scholar 

  7. Monasta L, Batty G, Cattaneo A, Lutje V, Ronfani L, Van Lenthe F et al. Early life determinants of overweight and obesity: a review of systematic reviews. Obes Rev 2010; 11: 695–708.

    Article  CAS  Google Scholar 

  8. Owen CG, Martin RM, Whincup PH, Smith GD, Cook DG . Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence. Pediatrics 2005; 115: 1367–1377.

    Article  Google Scholar 

  9. Amir LH, Donath SM . Socioeconomic status and rates of breastfeeding in Australia: evidence from three recent national health surveys. Med J Aust 2008; 189: 254–256.

    PubMed  Google Scholar 

  10. Binns CW, Scott JA . Breastfeeding: reasons for starting, reasons for stopping and problems along the way. Breastfeed Rev 2002; 10: 13–19.

    Google Scholar 

  11. Australian Institute of Health and Welfare 2010 Australian National Infant Feeding Survey: Indicator Results. Australian Institute of Health and Welfare: Canberra, 2011.

  12. Donath SM, Amir LH . Breastfeeding and the introduction of solids in Australian children: data from the 2001 National Health Survey. Aust N Z J Public Health 2005; 29: 171–175.

    Article  Google Scholar 

  13. Sloan S, Gildea A, Stewart M, Sneddon H, Iwaniec D . Early weaning is related to weight and rate of weight gain in infancy. Child Care Health Dev 2008; 34: 59–64.

    CAS  PubMed  Google Scholar 

  14. Lin SL, Leung GM, Lam TH, Schooling CM . Timing of solid food introduction and obesity: Hong Kong’s ‘children of 1997’ birth cohort. Pediatrics 2013; 131: e1459.

    Article  Google Scholar 

  15. Burnham L, Buczek M, Braun N, Feldman-Winter L, Chen N, Merewood A . Determining length of breastfeeding exclusivity: validity of maternal report 2 years after birth. J Hum Lact 2014; 30: 190–194.

    Article  Google Scholar 

  16. Li R, Scanlon KS, Serdula MK . The validity and reliability of maternal recall of breastfeeding practice. Nutr Rev. 2005; 63: 103–110.

    Article  Google Scholar 

  17. Newby RM, Davies PSW . A prospective study of the introduction of complementary foods in contemporary Australian infants: what, when and why? J Paediatr Child Health 2014; 51: 186–191.

    Article  Google Scholar 

  18. Newby R, Brodribb W, Ware RS, Davies PSW . Internet use by first-time mothers for infant feeding support. J Hum Lact 2015; 31: 416–424.

    Article  Google Scholar 

  19. Fein SB, Labiner-Wolfe J, Shealy KR, Li RW, Chen J, Grummer-Strawn LM . Infant feeding practices study II: study methods. Pediatrics 2008; 122: S28–S35.

    Article  Google Scholar 

  20. Australian Bureau of Statistics Census of Population and Housing: Socio-economic Indexes for Areas (SEIFA), Australia, 2011. Government of Australia: Canberra, 2011.

  21. Sheehan A, Schmied V, Barclay L . Exploring the process of women’s infant feeding decisions in the early postbirth period. Qual Health Res 2013; 23: 989–998.

    Article  Google Scholar 

  22. Forster DA, McLachlan HL, Lumley J . Factors associated with breastfeeding at six months postpartum in a group of Australian women. Int Breastfeed J 2006; 1: 18.

    Article  Google Scholar 

  23. Odom EC, Li R, Scanlon KS, Perrine CG, Grummer-Strawn L . Reasons for earlier than desired cessation of breastfeeding. Pediatrics 2013; 131: e726–e732.

    Article  Google Scholar 

  24. Tenfelde S, Zielinski R, Heidarisafa RL . Why WIC women stop breastfeeding: analysis of maternal characteristics and time to cessation. ICAN: Infant, Child, & Adolescent Nutrition 2013; 5: 207–214.

    Google Scholar 

  25. Li R, Fein SB, Chen J, Grummer-Strawn LM . Why mothers stop breastfeeding: mothers’ self-reported reasons for stopping during the first year. Pediatrics 2008; 122 (Supplement 2), S69–S76.

    Article  Google Scholar 

  26. Uvnas-Moberg K . Neuroendocrinology of the mother child interaction. Trends Endocrinol Metabol 2001; 7: 126–131.

    Article  Google Scholar 

  27. Kent JC, Hepworth AR, Sherriff JL, Cox DB, Mitoulas LR, Hartmann PE . Longitudinal changes in breastfeeding patterns from 1 to 6 months of lactation. Breastfeed Med 2013; 8: 401–407.

    Article  Google Scholar 

  28. Gatti L . Maternal perceptions of insufficient milk supply in breastfeeding. J Nurs Scholarsh 2008; 40: 355–363.

    Article  Google Scholar 

  29. Hurley KM, Black MM, Papas MA, Quigg AM . Variation in breastfeeding behaviours, perceptions, and experiences by race/ethnicity among a low-income statewide sample of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in the United States. Matern Child Nutr 2008; 4: 95–105.

    Article  Google Scholar 

  30. O’Brien M, Fallon AB, Brodribb W, Hegney D . Reasons for stopping breastfeeding: what are they, what characteristics relate to them ad what are the underlying factors? Birth Issues 2007; 15: 9.

    Google Scholar 

  31. Neifert M, DeMarzo S, Seacat J, Young D, Leff M, Orleans M . The influence of breast surgery, breast appearance, and pregnancy-induced breast changes on lactation sufficiency as measured by infant weight gain. Birth (Berkeley, Calif) 1990; 17: 31.

    Article  CAS  Google Scholar 

  32. Butte NFL-A, Mardia G, Garza C . Nutrient Adequacy of Exclusive Breastfeeding for the Term Infant during the First Six Months of Life. Department of Nutrition for Health and Development, Department of Child and Adolescent Health and Development, World Health Organisation: Geneva, 2002.

    Google Scholar 

  33. Feinstein JM, Berkelhamer JE, Gruszka ME, Wong CA, Carey AE . Factors related to early termination of breast-feeding in an urban population. Pediatrics 1986; 78: 210–215.

    CAS  PubMed  Google Scholar 

  34. Hoddinott P, Pill R . Nobody actually tells you: a study of infant feeding. Br J Midwifery 1999; 7: 558–565.

    Article  Google Scholar 

  35. Dykes F . Western medicine and marketing: construction of an inadequate milk syndrome in lactating women. Health Care Women Int 2002; 23: 492–502.

    Article  Google Scholar 

  36. Kronborg H, Vaeth M, Olsen J, Iversen L, Harder I . Early breastfeeding cessation: validation of a prognostic breastfeeding score. Acta Pædiatrica 2007; 96: 688–692.

    Article  Google Scholar 

  37. Ertem IO, Votto N, Leventhal JM . The timing and predictors of the early termination of breastfeeding. Pediatrics 2001; 107: 543–548.

    Article  CAS  Google Scholar 

  38. Lewallen LP, Dick MJ, Flowers J, Powell W, Zickefoose KT, Wall YG et al. Breastfeeding support and early cessation. J Obstet Gynecol Neonatal Nurs 2006; 35: 166–172.

    Article  Google Scholar 

  39. Walker M . Conquering common breast-feeding problems. J Perinat Neonatal Nurs 2008; 22: 267–274.

    Article  Google Scholar 

  40. Vieira F, Bachion MM, DDCF Mota, Munari DB . A systematic review of the interventions for nipple trauma in breastfeeding mothers. J Nurs Scholarsh: An official publication of Sigma Theta Tau International Honor Society of Nursing/Sigma Theta Tau 2013; 45: 116–125.

    Article  Google Scholar 

  41. Taveras EM, Capra AM, Braveman PA, Jensvold NG, Escobar GJ, Lieu TA . Clinician support and psychosocial risk factors associated with breastfeeding discontinuation. Pediatrics 2003; 112: 108–115.

    Article  Google Scholar 

  42. Witt AM, Smith S, Mason MJ, Flocke SA . Integrating routine lactation consultant support into a pediatric practice. Breastfeed Med 2012; 7: 38–42.

    Article  Google Scholar 

  43. Labarere J, Gelbert-Baudino N, Ayral A-S, Duc C, Berchotteau M, Bouchon N et al. Efficacy of breastfeeding support provided by trained clinicians during an early, routine, preventive visit: a prospective, randomized, open trial of 226 mother-infant pairs. Pediatrics 2005; 115: e139–e146.

    Article  Google Scholar 

  44. National Health and Medical Research Council Literature Review: Infant Feeding Guidelines. Department of Health and Ageing, National Health and Medical Research Council: Canberra, 2012.

  45. Newby R, Brodribb W, Ware RS, Davies PSW . Personal influences on infant feeding decisions for Queensland women in their first pregnancy. Breastfeed Med 2015 under review.

  46. Lin SL, Leung GM, Lam TH, Schooling CM . Timing of solid food introduction and obesity: Hong Kong’s ‘Children of 1997’ birth cohort. Pediatrics 2013; 131: e1459–e1467.

    Article  Google Scholar 

Download references

Acknowledgements

We thank and acknowledge all the mothers who took part in the Feeding Queensland Babies Study. Financial support: The production of this manuscript was financially supported by a donation from Nestle Nutrition Institute (Oceania).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R M Newby.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Newby, R., Davies, P. Why do women stop breast-feeding? Results from a contemporary prospective study in a cohort of Australian women. Eur J Clin Nutr 70, 1428–1432 (2016). https://doi.org/10.1038/ejcn.2016.157

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2016.157

This article is cited by

Search

Quick links