EAT FOR HEALTH Australian Dietary Guidelines

ENCOuRAGE, SuPPORT AND PROMOTE BREASTFEEDING

91

Guideline 4

Table 4.2: Factors associated with duration of exclusive breastfeeding

Association with longer duration
of exclusive breastfeeding Factor

Consistently positive • Higher level of maternal education

•   Support of midwives and community health professionals

•   Father’s preference for breastfeeding

•   Doctors’ support of breastfeeding

•   Pleasant birth experience (minimal complications)

•   Greater breastfeeding knowledge

•   Rural environment

•   Time decision to breastfeed is made (preferably before pregnancy

or early in pregnancy)

Consistently negative • lower socioeconomic background

•   Formula supplementation in maternity ward

•   Mother’s intention to use supplementation

•   Previous breastfeeding experience short-term (<5 weeks)

or absent

•   Newborn infant not rooming in with mother

•   Early use of pacifier

•   High number of intended hours of work per week after

maternity leave

•   Perceived insufficient milk supply and other breastfeeding

problems

•   Smoking, alcohol use

•   Intention to return to work before 6 months

Effect varies in different cultures • Maternal age

•   Vaginal delivery

•   Multiparity

Source: Summarised from Simopoulos et al 1995; Landers et al 1998; Scott & Binns 1999; Scott 1999; Scott 2001; Kramer et al
2002a; 2002b; Hector & King 2005; Britton et al 2007; Chung et al 2008.879,888-896

4.2.2 Infant growth

For ethical reasons, randomised control trials (RCTs) of breastfeeding are not possible. The best alternative is
to use RCTs of health promotion interventions to increase breastfeeding rates. For this reason, most evidence
is based on prospective cohort studies and one large health promotion RCT – the Promotion of Breastfeeding
Intervention Trial study.^897

Breastfed infants grow more slowly than formula-fed infants.8 74 A systematic review of 19 observational studies in
developed countries concluded that the cumulative difference in body weight at 12 months of age was 600–650g
less in infants breastfed for 12 months than formula-fed infants.^898 Differences in feeding behaviour and mother–
child interaction between breastfed and formula-fed infants may account for some of the differences reported.
For instance, breastfed infants showed a different suckling pattern, and appeared to have greater degree of control
over meal sizes and feeding intervals than infants who were formula-fed.^899