A large study in the US looked at mothers’ exclusive breastfeeding intentions and whether Baby Friendly hospital practices are associated with achieving these intentions. As part of the 2005–2007 Infant Feeding Practices Study II, women (3,006) completed an antenatal questionnaire and approximately monthly questionnaires during the 12 months after the birth. Mothers were asked antenatally about their plans for exclusive breastfeeding and subsequently if they equalled or exceeded their intention.

The researchers found that among women who intended to exclusively breastfeed (n=1,457), more than 85% intended to do so for 3 months or more - however, only 32.4% of mothers achieved their intended exclusive breastfeeding duration.

A total of 40% of mothers reported that their baby had received a supplementary feed in the hospital, and by the time they left hospital 15% had already given up exclusively breastfeeding. Mothers who were married and multiparous were more likely to achieve their exclusive breastfeeding intention, whereas mothers who were obese, smoked, or had longer intended exclusive breastfeeding duration were less likely to meet their intention. Beginning breastfeeding within 1 hour of birth and not being given supplementary feeds or pacifiers were associated with achieving exclusive breastfeeding intention. However, after adjustment for all other hospital practices, only not receiving supplementary feeds remained significant.

The researchers conclude that two-thirds of mothers who intend to exclusively breastfeed are not meeting their intended duration and they recommend that increased Baby-Friendly hospital practices, particularly giving only breastmilk in the hospital, may help more mothers achieve their exclusive breastfeeding intentions.

Perrine CG, Scanlon KS, Li R (et al) Baby-Friendly Hospital Practices and Meeting Exclusive Breastfeeding Pediatrics. published 4 June 2012, 10.1542/peds.2011-3633