A new University of Missouri study found that first-time mothers living in rural Missouri are more likely to stop breastfeeding earlier than urban and suburban moms. Researchers found that women who chose to discontinue breastfeeding lacked support, including access to lactation consultants, and had feelings of being overwhelmed.
The study was published in the Journal of Obstetric, Gynecologic and Neonatal Nursing, and included interviews with first-time mothers and found they discontinued breast feeding within days or weeks of leaving the hospital, even though they intended to continue longer.
“A lot of the women had to drive over an hour to deliver their babies or to get any sort of lactation help,” said Karry Weston, the study’s author. “For those people out there who have attempted breastfeeding, often times when you need help you need help now. It can’t wait a couple of days until you get reliable transportation to go and travel to this place where you need help.”
Weston, a postdoctoral fellow at MU’s Sinclair School of Nursing, grew up around pregnant women and babies in rural Missouri. Eventually she developed a passion for maternal child health. Weston worked at Hannibal Regional Hospital as a labor and delivery nurse and later a nursing instructor.
It’s known as the state’s first “baby-friendly” hospital, because of its work to increase breastfeeding in the community. She said during her time there she noticed a pattern. The women she helped to deliver their babies had stopped breastfeeding after they left the hospital. That ultimately led her to do a study.
She discovered that a lot of the women wanted to breastfeed, because of all of the benefits. They just didn’t have the help they needed when things got rough.
“It was really that they didn’t have the pragmatic knowledge to sustain breastfeeding,” said Weston. “Often, they didn’t even get the resources or teaching they really needed to leave the hospital. Maybe they weren’t latching fully before leaving the hospital. So they’re sent home to a place where they just can’t turn to a sister or mom, because they don’t have that, for help.”
She said it’s important to set up mothers for success before they’re discharged from the hospital. If not, the cycle will continue.
“If we have a game plan of this is who you’re going to call,” Weston said. “This is where you’re going to go. Really making sure that these mothers know and have a plan.”
Many of the mothers were also concerned that their babies weren’t getting enough milk. Oftentimes the mothers felt discouraged that their babies remained fussy even though they were able to get the baby to latch on. Instead they would rely on the breast pump.
“They would pump to determine how much they were making, which actually isn’t that reliable of an estimate,” she said. “Pumping is not the same as a baby latching. So they pump and they get an ounce or two, which is adequate. But they weren’t taught that that was adequate. So they would stop breastfeeding. And they would tell themselves, ‘I obviously can’t make enough milk to feed my infant.’”
Weston encourages mothers to count the number of wet diapers there are. That’s an easy indicator to know if your baby is getting enough to eat. Even though Weston is an advocate for breastfeeding, she said it’s more important to her that babies are fed and that their mothers aren’t judged for how they choose to do it.
“The women in my study felt judged either way,” Weston said. “Mother’s using formula felt judged by breastfeeders, because they hear those words, ‘Breast is best.’ So that made them feel like, 'Am I less [of] a mother when I’m trying my best?’ And then the breastfeeders felt judged often by their community for not covering up or not being conservative enough.”
Weston hopes her research will encourage more hospitals in rural communities to invest in lactation training for staff to prepare mothers choosing to breastfeed.
