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Barriers to Breastfeeding Success

Society norms, values and beliefs will influence your decision on how you feed your baby.

Most women select their feeding choice early in their pregnancy or some time before conception.

One of the key influences on your choice of how to feed your baby is the attitude of your partner to breastfeeding.  It is important to discuss your feeding choice with your partner and whanau early so that they can support you.

Bottle-feeding culture

Until the 1960's babies were breastfed by their mother or a wet nurse. Infant formula (also known as artificial baby milk or a breastmilk substitute) was designed for emergency use when a baby was abandoned or following a mother's death.

Breastfeeding is the foundation for optimum nutrition from birth however this message has been eroded over the years, and breastfeeding is no longer the natural choice of all women.

The bottle-feeding culture is largely perceived as the cultural norm in New Zealand. For many women breastfeeding is only viewed as acceptable for a short period postnatally, but beyond this bottle-feeding is normal.

In the past maternity hospitals have reinforced this culture by making bottles available in wards, and by the eagerness with which some staff would recommend to bottle-feed babies in hospitals so as not to wake the mother. The prevalence of marketing infant formula and the limited promotion of breastfeeding in New Zealand also contribute to the normalisation of a bottle-feeding culture.

Barriers during the antenatal and birth period

  • Limited or no antenatal education - Mothers who do not attend antenatal classes are less likely to breastfeed.

  • Maternal age - Young maternal age (under 20 years) and not being married were factors found to be associated with a lower rate of breastfeeding at four weeks after birth.

  • Low birth weight and multiple births - Babies born under 2500g, twins and babies admitted to a neonatal unit are less likely to breastfeed at four weeks.

Barriers during the postnatal period

  • Poor initiation of breastfeeding - To initiate breastfeeding successfully, infants should be allowed to breastfeed within an hour of birth when both their reflexes and mother's sensitivity to tactile stimuli of the nipple are strongest.

  • Perceived inadequate breast milk supply - According to a 1995 study, inadequate breastmilk supply was the most common reason women gave for stopping breastfeeding at all ages in the first six months.

  • Poor suckling/attachment - In the first week postpartum, breast problems such as sore nipples, suckling difficulties and attachment difficulties were the main reasons for stopping breastfeeding.

  • Pacifiers - A study of 1500 New Zealand infants found that not exclusively breastfeeding at time of discharge from hospital was associated with subsequent pacifier (dummy) use.

  • Infant formula - Babies who received infant formula at any time in the first month, irrespective of quantity, are more than three times more likely to cease breastfeeding activity early.

  • Early weaning and introduction of solids - Lack of support will often lead to early weaning, and this is particular prevalent when a mother returns to work. A 1997 study by Plunket found Maori and Pacific peoples are more likely than Europeans to introduce solids before 26 weeks.

  • Maternal smoking - Maternal smoking has been linked to early weaning, lowered milk production and inhibition of milk ejection (let-down) reflex. The results of a 1996/97 New Zealand Health survey showed that approximately one-quarter of Kiwis were current smokers: 26.4 percent of men and 23.5 percent of women.

Your health professional

BFHI and BFCI work to ensure that the health professionals caring for you give clear, accurate and unbiased information on feeding your baby.  We want you to make an informed decision on how to feed your baby. 

Breastfeeding is natural but that doesn't mean it's always easy. Don't hesitate to contact your healthcare provider or a certified lactation consultant if you need help or support.

For further support google "breastfeeding support" for your local area or check out our page on breastfeeding advocates and websites.