1.4 Common breastfeeding concerns
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![]() Key Points - Case Study AJoanne, aged 32, a regular patient, comes to see you when she is 12 weeks pregnant with her first baby. She has just returned from a trip around Australia and her pregnancy was confirmed by a doctor in the town they were in at the time. She has copies of her baseline blood tests with her and all are normal. Would you discuss breastfeeding at this visit?
What information would you give?
Why do breastfeeding alternatives have different effects?
What are mothers' common and valid concerns about breastfeeding?
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What are mothers' common and valid concerns about breastfeeding?
Common and valid concerns often held by mothers include:
- uncertainty regarding their chances of success
- how they can return to paid work and continue to breastfeed
- whether their partner will feel left out if they breastfeed
- embarrassment about breastfeeding in public
Women may think they should not breastfeed
- if they smoke
- have an occasional alcoholic drink
- eat 'junk food'
Exploring these and other concerns and providing information, reassurance and other resources is useful in allaying anxiety and preparing the parents for their changing role. For example:
Encourage acquiring knowledge and support networks
Discuss the most appropriate outcome depending on individual circumstances
Encourage both parents to develop their own unique roles
Support breastfeeding with confidence, anywhere the mother and baby may be
Assist women to quit smoking and limit alcohol intake while breastfeeding, but it's better to be breastfed than formula fed even if the mother smokes.
While nicotine and alcohol enter breastmilk, any adverse effects in the infant are much smaller than the adverse effects of alternatives to breastmilk.
Women who smoke are less likely to initiate breastfeeding,3 and breastfeed for a shorter duration4. Their infants are exposed to nicotine and other substances through the air they breathe and their skin regardless of the method of infant feeding. Breastfeeding significantly modifies the effect of smoking on the risk of respiratory tract infections in the infant5. It is recommended that women stop smoking during pregnancy and lactation. However, it is more detrimental for an infant of a mother who continues to smoke to be formula fed than breastfed.
Alcohol passes readily into milk with levels peaking 30-60 minutes after ingestion. As the mother metabolises the alcohol, levels in milk reduce in parallel to maternal plasma levels. By 2 hours following the ingestion of one standard drink there is minimal amounts of alcohol in breastmilk. The effects of alcohol on the breastfed infant are dependent on the amount and frequency of maternal ingestion with social drinking having a minimal impact6.
Discuss healthy eating for maternal well-being
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![]() Case Study ActivityThink about what your response would be to the scenario presented, write it into the exercise, then submit it and read the suggestions given. |
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Notes
- # Hawkins SS et al. (2007) The impact of maternal employment on breast-feeding duration in the UK Millennium Cohort Study
- # McVeagh P (2001) Breastfeeding - help!
- # Donath SM et al. (2004) The relationship between maternal smoking and breastfeeding duration after adjustment for maternal infant feeding intention
- # Giglia R et al. (2006) Maternal cigarette smoking and breastfeeding duration.
- # Woodward A et al. (1990) Acute respiratory illness in Adelaide children: breast feeding modifies the effect of passive smoking
- # McAfee G ( 2007) Drugs of abuse and breastfeeding.
- # Hopkinson JM (2007) Nutrition in lactation