Barriers to Breast Feeding: A Review

Abstract

Context: Exclusive breast feeding, (EBF) protects young infants from infectious illnesses; various factors, including pacifier use, may adversely affect the initiation and duration of breast feeding. Evidence Acquisition: Mesh terms relating to EBF were used to search articles published in PubMed between 2000 and 2014. In addition to studies done outside Iran, articles from Iran addressing the issue of pacifier use in infants that had not been published in the PubMed, but were collected from Iranian journals, were also included. Regarding pacifier use, search was limited to papers published during the last 5 years. Results:Rates of breastfeeding at 6 months were reported to vary from 3% to 95% and EBF from less than 1% to 33% in different parts of the world. A negative association between pacifier use and duration of breastfeeding was reported by 10 authors, with a meta-analysis from Turkey reporting a Risk Ratio of 1.952, 95% CI: 1.662 -2.293. Some researchers, although observed an association between pacifier use and early cessation of EBF, but refuted a causal relationship. Conclusions: As available data on the effect of pacifier use is conflicting, and continuation of breast feeding till 6 months of age is crucial for optimal health outcomes in infants, it is prudent to avoid pacifier use totally or at least till breast feeding is established.

Prevalence and Predictive Factors of Exclusive Breastfeeding in the First Six Months of Life

“…Besides, maternal employment is a major factor in short-term breastfeeding patterns. 15 In fact, in our study, higher mixed feeding rates were observed in infants that have already started attending nurseries at six months because their mothers returned to work. Beyond that, 30% of these women were not entitled to a breastfeeding schedule, suggesting the importance of providing breastfeeding breaks by employers and providing access to these women to a private area where they may pump and store breastmilk.…”

“…Beyond that, 30% of these women were not entitled to a breastfeeding schedule, suggesting the importance of providing breastfeeding breaks by employers and providing access to these women to a private area where they may pump and store breastmilk. 15 EBF at three months old was more common in infants from mothers and fathers who are unable to communicate in Portuguese. Some reports describe exclusive breastfeeding adoption being more like a socio-cultural rather than technical process l. 16 There are some particularities about the African culture that may have a protective influence in EBF including grandmothers and other extended family members who frequently live together and have significant roles in childcare.…”

“…Other similar factors were NICU admission and cesarean delivery, which could be related to delayed skin-to skin contact and, therefore, early discontinuation of EBF. 15 On the other hand, factors that promoted EBF at discharge were gestational age (> 37 weeks), birthweight between 2500 g and 3999 g and shorter hospital stay (< 72 hours). A possible explanation is that some of the reasons that justify formula introduction, as hypoglycemia, are less common in newborns with normal birthweight and gestational age.…”

“…In agreement, Setegn et al showed that mothers who initiated breastfeeding within one hour of birth were two times more likely to practice exclusive breastfeeding than mothers who initiated it afterwards. 15 Furthermore, several observational studies have shown a strong association between early pacifier use and early cessation of EBF. 19 Of note, the use of pacifiers in our study adversely affected breastfeeding compliance at all ages (at discharge, three and six months).…”