References

Ahluwalia IB, Morrow B, Hsia J. Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System. Pediatrics. 2005; 116:(6)1408-1412 https://doi.org/10.1542/peds.2005-0013

Binns CW, Scott JA. Breastfeeding: reasons for starting, reasons for stopping and problems along the way. Breastfeeding Review. 2002; 10:(2)13-19

Borders N. After the afterbirth: a critical review of postpartum health relative to method of delivery. Journal of Midwifery and Women's Health. 2006; 51:(4)242-248 https://doi.org/10.1016/j.jmwh.2005.10.014

Bramson L, Lee JW, Moore E, Montgomery S, Neish C, Bahjri K, Melcher CL. Effect of early skin-to-skin mother-infant contact during the first 3 hours following birth on exclusive breastfeeding during the maternity hospital stay. J Hum Lact.. 2010; 26:(2)130-137 https://doi.org/10.1177/0890334409355779

Brown A, Jordan S. Active management of the third stage of labor may reduce breastfeeding duration due to pain and physical complications. Breastfeeding Medicine. 2014; 9:(10)494-503 https://doi.org/10.1089/bfm.2014.0048

Brown A, Rance J, Bennett P. Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. Journal of Advanced Nursing. 2015; 72:(2)273-282 https://doi.org/10.1111/jan.12832

Chaput KH, Nettel-Aguirre A, Musto R, Adair CE, Tough SC. Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of women who have given birth in Calgary: a prospective cohort study. CMAJ Open. 2016; 4:(1)E103-E109 https://doi.org/10.9778/cmajo.20150009

Declercq E, Cunningham DK, Johnson C, Sakala C. Mothers' reports of postpartum pain associated with vaginal and caesarean deliveries: results of a national survey. Birth. 2008; 35:(1)16-24 https://doi.org/10.1111/j.1523-536X.2007.00207.x

do Espírito Santo LC, De Oliveira LD, Giugliani ERJ. Factors associated with low incidence of exclusive breastfeeding for the first 6 months. Birth. 2007; 34:212-219 https://doi.org/10.1111/j.1523-536X.2007.00173.x

Eisenach JC, Pan PE, Smiley R, Lavand'homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008; 140:(1)87-94 https://doi.org/10.1016/j.pain.2008.07.011

Feenstra MM, Kirkeby MJ, Thygesen MK, Danbjørg DB, Kronborg H. Early breastfeeding problems: a mixed method study of mothers' experiences. Sexual and Reproductive Healthcare. 2018; 16:167-174 https://doi.org/10.1016/j.srhc.2018.04.003

Galipeau R, Dumas L, Lepage M. Perception of not having enough milk and actual milk production of first time breastfeeding mothers: is there a difference?. Breastfeeding Medicine. 2017; 12:(4)210-217 https://doi.org/10.1089/bfm.2016.0183

Gatti L. Maternal perceptions of insufficient milk supply in breastfeeding. Journal of Nursing Scholarship. 2008; 40:(4)355-363 https://doi.org/10.1111/j.1547-5069.2008.00234.x

Gutke A, Josefsson A, Öberg B. Pelvic girdle pain and lumbar pain in relation to postpartum depressive symptoms. Spine. 2007; 32:(13)1430-1436 https://doi.org/10.1097/BRS.0b013e318060a673

Hill PD, Aldag JC. Predictors of term infant feeding at week 12 postpartum. Journal of Perinatal Neonatal Nursing. 2007; 21:(3)250-255 https://doi.org/10.1097/01.JPN.0000285816.44022.a3

Infant Feeding Survey, 2010, 2nd edn. : UK Data Service; 2013 https://doi.org/10.5255/UKDA-SN-7281-2

Kent JC, Ashton E, Hardwick CM, Rowan MK, Chia ES, Fairclough KA, Menon LL, Scott C, Mather-McCaw G, Navarro K, Geddes DT. Nipple pain in breastfeeding mothers: incidence, causes and treatments. International Journal of Environmental Research and Public Health. 2015; 12:(10)12247-12263 https://doi.org/10.3390/ijerph121012247

Lau Y, Tha PH, Ho-Lim SST, Wong LY, Lim PI, Citra Nurfarah BZM, Shorey S. An analysis of the effects of intrapartum factors, neonatal characteristics, and skin-to-skin contact on early breastfeeding initiation. Maternal and Child Nutrition. 2017; 14:(1) https://doi.org/10.1111/mcn.12492

Mekonnen A, Yehualashet S, Bayleyegn D. The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and low birthweight infants: a meta-analysis of published studies. International Breastfeeding Journal. 2019; 14:(12) https://doi.org/10.1186/s13006-019-0206-0

Mohammadzadeh A, Farhat A, Esmaeily H. The effect of breast milk and lanolin on sore nipples. Saudi Medical Journal. 2005; 26:(8)1231-1234

Nyqvist KH, Ewald U. Successful breast feeding in spite of early mother-baby separation for neonatal care. Midwifery. 1997; 13:(1)24-31 https://doi.org/10.1016/S0266-6138(97)90029-2

Odom EC, Ruowei L, Scanlon KS, Perrine CG, Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding. Pediatrics. 2013; 131:(3)e726-e732 https://doi.org/10.1542/peds.2012-1295

Quigley MA, Carson C. Breastfeeding in the 21st century. Lancet. 2016; 387:475-490 https://doi.org/10.1016/S0140-6736(16)30534-7

Rajan L. The impact of obstetric procedures and analgesia/anaesthesia during labour and delivery on breastfeeding. Midwifery. 1994; 10:87-105 https://doi.org/10.1016/S0266-6138(05)80250-5

Rapley G. Keeping mothers and babies together–breastfeeding and bonding. RCM Midwives. 2002; 5:(10)332-334

Stainton CM, Edwards S, Jones B, Switonski C. The nature of maternal postnatal pain. Journal of Perinatal Education. 1999; 8:(2)1-10 https://doi.org/10.1624/105812499X87060

Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387:(10017)475-490 https://doi.org/10.1016/S0140-6736(15)01024-7

Walker M. Formula supplementation of breastfed infants: helpful or hazardous?. Childhood Obesity and Nutrition. 2015; 7:(4)198-207 https://doi.org/10.1177/1941406415591208

World Health Organization. Breastfeeding. 2019. https://www.who.int/nutrition/topics/exclusive_breastfeeding/en/ (accessed 29 May 2019)

The impact of birth-related injury and pain on breastfeeding outcomes

02 January 2020
15 min read
Volume 28 · Issue 1

Abstract

Background

Reasons for premature discontinuation of breastfeeding are complex; a variety of social, psychological and physical factors may contribute to a deviation from a mother's breastfeeding plan.

Aims

To investigate how actual experiences of birth and breastfeeding differed from the mother's pre-birth intentions, and any subsequent perceived impact on breastfeeding experience.

Methods

Data was collected via an online survey of UK-based women (n=1 000).

Findings

Respondents faced a variety of challenges when breastfeeding, including nipple soreness and pain, concerns around milk insufficiency, and birth-related pain which impacted their ability to breastfeed comfortably. Predominantly, birth-related pain made breastfeeding difficult rather than preventing it, however 5% of mothers surveyed cited it as contributing to premature cessation of breastfeeding.

Conclusions

Pain relating to birth may be an under-considered factor in early cessation of breastfeeding. Considering the challenges experienced when establishing and maintaining breastfeeding, it is essential to consider the cumulative pain and discomfort experienced from all sources.

Human milk is acknowledged to be the optimum source of nutrition for infants, while also being beneficial to maternal health (Victora et al, 2016). As such, the World Health Organization ([WHO], 2019) recommends exclusive breastfeeding for the first six months of an infant's life, followed by breastfeeding and appropriate complementary foods up to two years of age or beyond. Despite this, breastfeeding rates in the UK remain some of the lowest in the world; the last UK-wide infant feeding survey reporting that while 81% of mothers initiated breastfeeding, exclusive breastfeeding rates declined to less than 25% by six weeks (IFF Research, 2013).

The reasons for premature discontinuation of breastfeeding are complex and varied at what is a highly emotive time in a new mother's life. These issues may be social, psychological or physical (IFF Research, 2013; Odom et al, 2013). Much of the research into physical problems experienced by breastfeeding mothers focuses on issues relating to breastfeeding itself, such as latch difficulties, nipple pain and perceived milk insufficiencies (Binns and Scott, 2002; Mohammadzadeh et al, 2005; Kent et al, 2015). However, in understanding breastfeeding difficulties, other factors may also affect a mother's ability to establish a sustainable breastfeeding relationship with her infant.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month