Factors influencing cessation of exclusive breastfeeding before six months of age

Authors

DOI:

https://doi.org/10.31211/rpics.2024.10.1.327

Keywords:

Breastfeeding, Triggering factors, Early weaning, Infant, Scoping Review

Abstract

Background: Exclusive breastfeeding is crucial for infant health and development, but many factors can lead to its early cessation. Understanding these factors is essential for developing effective interventions. Objective: To identify and categorize the factors influencing the early cessation of exclusive breastfeeding before six months of age. Methods: This scoping review utilized the EbscoHost database aggregator. Articles published between 2020 and 2023, available in full English, Portuguese, and Spanish text, were selected. The search was conducted using DeCS/MeSH vocabulary to obtain synonyms and Boolean operators, with article screening and selection independently performed by three reviewers using the Rayyan tool. Results: Seven studies were included in the review. Maternal factors such as being a first-time mother, low educational level, negative attitudes toward childbirth, and lack of intention to breastfeed increase the likelihood of early breastfeeding cessation. Maternal anxiety and depression negatively impact breastfeeding self-efficacy. Early introduction of solid foods and formula, as well as the use of pacifiers and bottle nipples, are associated with a shorter duration of breastfeeding. Cesarean deliveries and negative attitudes toward childbirth also negatively impact breastfeeding success. Conclusions: This review highlights the need for prenatal education and counseling programs, workplace support policies, mental health interventions, and protection for women in situations of domestic violence. Additionally, it recommends practices such as immediate skin-to-skin contact and continuous breastfeeding support, as per WHO and UNICEF guidelines, to improve exclusive breastfeeding rates.

Downloads

Download data is not yet available.

References

Abreu, A. D., Oliveira, E. F. B. de, Vasconcelos, É. L. P., Silva, S. D. B., & Granito, C. C. D. (2019). O aleitamento materno e seu impacto social. Revista Eletrônica da Jornada de Pesquisa e Iniciação Científica (JOPIC), 2(5), 77–83. https://bit.ly/44PqCKc

Abuchaim, E. D. S. V., Marcacine, K. O., Coca, K. P., & Silva, I. A. (2023). Ansiedade materna e sua interferência na autoeficácia para amamentação. Acta Paulista de Enfermagem, 36(eAPE02301). https://doi.org/mk3k

Adedinsewo, D. A., Fleming, A., Steiner, M., Meaney, M., & Girard, A. (2014). Maternal anxiety and breastfeeding. Journal of Human Lactation, 30(1), 102–109. https://doi.org/f5rfmc

Amaral, L. J. X., Sales, S. D. S., Carvalho, D. P. D. S. R. P., Cruz, G. K. P., Azevedo, I. C. D., & Ferreira Júnior, M. A. (2015). Fatores que influenciam na interrupção do aleitamento materno exclusivo em nutrizes. Revista Gaúcha de Enfermagem, 36(spe), 127–134. https://bit.ly/4aKJ9Ji

Araújo, O. D. D., Cunha, A. L. D., Lustosa, L. R., Nery, I. S., Mendonça, R. D. C. M., & Campelo, S. M. D. A. (2008). Aleitamento materno: Fatores que levam ao desmame precoce. Revista Brasileira de Enfermagem, 61(4), 488–492. https://doi.org/bsns7v

Aromataris, E., Lockwood, C., Porritt, K., Pilla, B., & Jordan, Z. (2024). JBI manual for evidence synthesis. JBI. https://doi.org/gsmg

Bai, D. L., Wu, K. M., & Tarrant, M. (2013). Association between intrapartum interventions and breastfeeding duration. Journal of Midwifery & Women’s Health, 58(1), 25–32. https://doi.org/f4n8kn

Binns, C., Lee, A., Sauer, K., & Hewitt, K. (2012). Reported breastfeeding rates in the Asia-pacific region. Current Pediatric Reviews, 8(4), 339–345. https://doi.org/mw66

Biro, M. A., Sutherland, G. A., Yelland, J. S., Hardy, P., & Brown, S. J. (2011). In-hospital formula supplementation of breastfed babies: A population-based survey. Birth, 38(4), 302–310. https://doi.org/fst6dk

Branco, J., Manuel, A. R., Completo, S., Marques, J., Antão, R. R., Gago, C. P., Paulino, E., Voutsen, O., & Barroso, R. (2023). Prevalence and predictive factors of exclusive breastfeeding in the first six months of life. Acta Médica Portuguesa, 36(6), 416–423. https://doi.org/mk35

Brown, A., & Lee, M. D. (2015). Early influences on child satiety‐responsiveness: The role of weaning style. Pediatric Obesity, 10(1), 57–66. https://doi.org/f63cxj

Cohen, R., Brown, K., Dewey, K., Canahuati, J., & Rivera, L. L. (1994). Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: A randomised intervention study in Honduras. The Lancet, 344(8918), 288–293. https://doi.org/bkk9d5

Cooklin, A., Amir, L., Nguyen, C. D., Buck, M., Cullinane, M., Fisher, J., & Donath, S. (2018). Physical health, breastfeeding problems and maternal mood in the early postpartum: A prospective cohort study. Archives of Women's Mental Health, 21(3), 365–374. https://doi.org/gdj947

Dennis, C. L. (2002). Breastfeeding initiation and duration: A 1990-2000 literature review. Journal of Obstetric, Gynecologic & Neonatal Nursing, 31(1), 12–32. https://doi.org/fs39bw

Dykes, F., & Flacking, R. (2010). Encouraging breastfeeding: A relational perspective. Early Human Development, 86(11), 733–736. https://doi.org/cjtr9q

Fein, S. B., & Roe, B. (1998). The effect of work status on initiation and duration of breast-feeding. American Journal of Public Health, 88(7), 1042–1046. https://doi.org/chj2kj

Feldman, R., Granat, A., Pariente, C., Kanety, H., Kuint, J., & Gilboa-Schechtman, E. (2009). Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation, and stress reactivity. Journal of the American Academy of Child and Adolescent Psychiatry, 48(9), 919–927. https://doi.org/fcqh25

Ferreira, C. E. G. (2019). Fatores que influenciam o abandono da amamentação na população portuguesa: Revisão integrativa com base nas publicações constantes no RCAAP [Dissertação de Mestrado, Escola Superior de Enfermagem do Porto, ESEP]. https://bit.ly/3TybInF

Gabay, Z. P., Gondwe, K. W., & Topaz, M. (2021). Predicting risk for early breastfeeding cessation in Israel. Maternal and Child Health Journal, 26(6), 1261–1272. https://doi.org/mk36

Garwolińska, D., Namieśnik, J., Kot-Wasik, A., & Hewelt-Belka, W. (2018). Chemistry of human breast milk—a comprehensive review of the composition and role of milk metabolites in child development. Journal of Agricultural and Food Chemistry, 66(45), 11881–11896. https://doi.org/gfqp7n

Geraldo, C., Rodeia, C., Silva, D., Guerreiro, I., Varela, M., Silva, S., Goes, M., João, A. S., Coelho, A., Dias, A., & Lusquinhos, L. (2023). Benefícios do aleitamento materno e a importância dos cuidados de enfermagem para a adesão à amamentação exclusiva. Revista Ibero-Americana de Saúde e Envelhecimento, 9, 6–21. https://doi.org/mk38

Gibbons, L., Belizán, J. M., Lauer, J. A., Betrán, A. P., Merialdi, M., & Althabe, F. (2010). The global numbers and costs of additionally needed and unnecessary cesarean sections performed per year: Overuse as a barrier to universal coverage (World Health Report 30; pp. 1–31). https://shre.ink/822I

Handlin, L., Jonas, W., Petersson, M., Ejdebäck, M., Ransjö-Arvidson, A.-B., Nissen, E., & Uvnäs-Moberg, K. (2009). Effects of sucking and skin-to-skin contact on maternal ACTH and cortisol levels during the second day postpartum—influence of epidural analgesia and oxytocin in the perinatal period. Breastfeeding Medicine, 4(4), 207–220. https://doi.org/d64z3q

Howard, C. R., Howard, F. M., Lanphear, B., Eberly, S., deBlieck, E. A., Oakes, D., & Lawrence, R. A. (2003). Randomized clinical trial of pacifier use and bottle-feeding or cupfeeding and their effect on breastfeeding. Pediatrics, 111(3), 511–518. https://doi.org/bts3rt

Jama, N. A., Wilford, A., Masango, Z., Haskins, L., Coutsoudis, A., Spies, L., & Horwood, C. (2017). Enablers and barriers to success among mothers planning to exclusively breastfeed for six months: a qualitative prospective cohort study in KwaZulu-Natal, South Africa. International Breastfeeding Journal, 12(1), 43. https://doi.org/gb37gx

Karlström, A., Engström‐Olofsson, R., Norbergh, K., Sjöling, M., & Hildingsson, I. (2007). Postoperative pain after cesarean birth affects breastfeeding and infant care. Journal of Obstetric, Gynecologic & Neonatal Nursing, 36(5), 430–440. https://doi.org/fwbz7g

Kendall-Tackett, K. A. (2007). Violence against women and the perinatal period: The impact of lifetime violence and abuse on pregnancy, postpartum, and breastfeeding. Trauma, Violence, & Abuse, 8(3), 344–353. https://doi.org/bfzdqw

Kronborg, H., & Foverskov, E. (2020). Multifactorial influence on duration of exclusive breastfeeding; a Danish cohort study. PLOS ONE, 15(9), Artigo e0238363. https://doi.org/mk4b

Lau, Y., & Chan, K. S. (2007). Influence of intimate partner violence during pregnancy and early postpartum depressive symptoms on breastfeeding among chinese women in Hong Kong. Journal of Midwifery & Women’s Health, 52(2), e15–e20. https://doi.org/bv9w79

Lechosa-Muñiz, C., Paz-Zulueta, M., Sáez De Adana Herrero, M., Cornejo Del Rio, E., Mateo Sota, S., Llorca, J., & Cabero-Perez, M. J. (2020). Health care costs associated to type of feeding in the first year of life. International Journal of Environmental Research and Public Health, 17(13), 4719. https://doi.org/gpfwfz

Lessa, A., Garcia, A. L., Emmett, P., Crozier, S., Robinson, S., Godfrey, K. M., & Wright, C. M. (2020). Does early introduction of solid feeding lead to early cessation of breastfeeding? Maternal & Child Nutrition, 16(4), e12944. https://doi.org/mk4g

Long, A., Mintz-Woo, K., Daly, H., O’Connell, M., Smyth, B., & Murphy, J. D. (2021). Infant feeding and the energy transition: a comparison between decarbonising breastmilk substitutes with renewable gas and achieving the global nutrition target for breastfeeding. Journal of Cleaner Production, 324, Artigo 129280. https://doi.org/gtbzrz

Lopes, C., Torres, D., Oliveira, A., Severo, M., Alarcão, V., Guiomar, S., Mota, J., Teixeira, P., Rodrigues, S., Lobato, L., Magalhães, V., Correia, D., Carvalho, C., Pizarro, A., Marques, A., Vilela, S., Oliveira, L., Nicola, P., Soares, S., & Ramos, E. (2017). Inquérito Alimentar Nacional e de Atividade Física, IAN-AF 2015-2016: Relatório de resultados. Universidade do Porto. https://bit.ly/3Txt6ZA

McDonald, S. D., Pullenayegum, E., Chapman, B., Vera, C., Giglia, L., Fusch, C., & Foster, G. (2012). Prevalence and predictors of exclusive breastfeeding at hospital discharge. Obstetrics & Gynecology, 119(6), 1171–1179. https://doi.org/mw3w

Melo, L. C. D. O. (2020). Influência dos transtornos depressivo e de ansiedade na autoeficácia materna para amamentação [Tese de doutoramento, Universidade de São Paulo, USP]. https://bit.ly/3PRMONC

Mercan, Y., & Tari Selcuk, K. (2021). Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women. PLOS ONE, 16(4), e0249538. https://doi.org/mq3q

Metheny, N., & Stephenson, R. (2020). Is intimate partner violence a barrier to breastfeeding? An analysis of the 2015 Indian National Family Health Survey. Journal of Family Violence, 35(1), 53–64. https://doi.org/gj2rhb

Mirkovic, K. R., Perrine, C. G., Scanlon, K. S., & Grummer-Strawn, L. M. (2014). Maternity leave duration and full-time/part-time work status are associated with us mothers’ ability to meet breastfeeding intentions. Journal of Human Lactation, 30(4), 416–419. https://doi.org/f6m565

Mohapatra, I., & Samantaray, S. R. (2023). Breastfeeding and environmental consciousness: a narrative review of environmental implications and potential contributions to reduce waste and energy consumption. Cureus. https://doi.org/mw3x

Moniz Tavares, M. F., Santos, A. P., Silva, S., & Mendes, J. (2023). A influência da imagem corporal da grávida na sua decisão em amamentar: Uma revisão sistemática da literatura. Revista Portuguesa de Investigação Comportamental e Social, 9(1), 1–12. https://doi.org/mk4h

Moore, E. R., Anderson, G. C., Bergman, N., & Dowswell, T. (2012). Early skin-to-skin contact for mothers and their healthy newborn infants. The Cochrane Collaboration (Ed.), Cochrane database of systematic reviews (p. CD003519.pub3). John Wiley & Sons, Ltd. https://doi.org/mw32

Oakley, L. L., Henderson, J., Redshaw, M., & Quigley, M. A. (2014). The role of support and other factors in early breastfeeding cessation: an analysis of data from a maternity survey in England. BMC Pregnancy and Childbirth, 14(1), Artigo 88. https://doi.org/gbfszr

Ogbuanu, C., Glover, S., Probst, J., Liu, J., & Hussey, J. (2011). The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics, 127(6), e1414–e1427. https://doi.org/bzdbpb

Pluymen, L. P. M., Wijga, A. H., Gehring, U., Koppelman, G. H., Smit, H. A., & van Rossem, L. (2018). Early introduction of complementary foods and childhood overweight in breastfed and formula-fed infants in the Netherlands: the PIAMA birth cohort study. European Journal of Nutrition, 57(5), 1985–1993. https://doi.org/gdxdxg

Pérez‐Escamilla, R., Hromi‐Fiedler, A., Rhodes, E. C., Neves, P. A. R., Vaz, J., Vilar‐Compte, M., Segura‐Pérez, S., & Nyhan, K. (2022). Impact of prelacteal feeds and neonatal introduction of breast milk substitutes on breastfeeding outcomes: A systematic review and meta‐analysis. Maternal & Child Nutrition, 18(S3), e13368. https://doi.org/mk4n

Rollins, N. C., Bhandari, N., Hajeebhoy, N., Horton, S., Lutter, C. K., Martines, J. C., Piwoz, E. G., Richter, L. M., & Victora, C. G. (2016). Why invest, and what it will take to improve breastfeeding practices? The Lancet, 387(10017), 491–504. https://doi.org/gfgrzp

Rowe‐Murray, H. J., & Fisher, J. R. W. (2002). Baby friendly hospital practices: cesarean section is a persistent barrier to early initiation of breastfeeding. Birth, 29(2), 124–131. https://doi.org/cq7vvx

Santos, A. P., Freitas, L. de F. M. F., & Tavares, M. F. M. (2021). Aleitamento materno na região autónoma dos açores. Estudo de incidência e prevalência até aos 12 meses de vida [Relatório de Investigação, Universidade dos Açores, UAc]. https://bit.ly/49MB5b3

Silva, J. S., Flor-de-Lima, F., & Soares, H. (2021). Aleitamento materno exclusivo: Prevalência na maternidade e durante o segundo mês de vida. Acta Portuguesa de Nutrição, 24, 18–20. https://doi.org/mq3r

Silverman, J. G., Decker, M. R., Reed, E., & Raj, A. (2006). Intimate partner violence around the time of pregnancy: association with breastfeeding behavior. Journal of Women’s Health, 15(8), 934–940. https://doi.org/d7ds9s

Tuthill, E. L., McGrath, J. M., Graber, M., Cusson, R. M., & Young, S. L. (2016). Breastfeeding self-efficacy: A critical review of available instruments. Journal of Human Lactation, 32(1), 35–45. https://doi.org/f76xzb

Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/gfd8vk

United Nations International Children's Emergency Fund (Ed.). (2019). Children, food and nutrition. UNICEF. https://uni.cf/4cnnN6y

United Nations International Children's Emergency Fund. (2022). Intimated partner violence and breastfeeding: A summary of the evidence base. UNICEF. https://uni.cf/3U92ApO

United Nations International Children's Emergency Fund & World Health Organization. (2023). Global Breastfeeding Scorecard, 2023: Rates of breastfeeding increase around the world through improved protection and support. https://uni.cf/43gx0Jz

World Health Organization. (2017). Guideline: Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. World Health Organization. https://bit.ly/49MSwId

World Health Organization. (2023). Infant and young child feeding [dataset]. https://bit.ly/4c8TErp

World Health Organization & United Nations International Children's Emergency Fund. (2020). Baby-friendly hospital initiative training course for maternity staff: Participant’s manual. World Health Organization; WHO IRIS. https://bit.ly/3PkcCS5

Widström, A., Brimdyr, K., Svensson, K., Cadwell, K., & Nissen, E. (2019). Skin‐to‐skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatrica, 108(7), 1192–1204. https://doi.org/gh9fxc

Wouk, K., Stuebe, A. M., & Meltzer-Brody, S. (2017). Postpartum mental health and breastfeeding practices: an analysis using the 2010–2011 pregnancy risk assessment monitoring system. Maternal and Child Health Journal, 21(3), 636–647. https://doi.org/f9393v

Published

2024-05-24

How to Cite

Carvalho, S., Rei, P., Moniz, X., Santos, A. P., Tavares, M., & Tavares, P. (2024). Factors influencing cessation of exclusive breastfeeding before six months of age . Portuguese Journal of Behavioral and Social Research, 10(1), 1–16. https://doi.org/10.31211/rpics.2024.10.1.327

Issue

Section

Review Paper

Most read articles by the same author(s)