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Breastfeeding twice as likely after birth at home than in hospital

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There is a strong positive relationship between planned birth at home and breastfeeding rates, according to researchers.

Their study review found breastfeeding was twice as likely among mothers in UK and Ireland who had a planned home birth, compared to hospital births.

“Hopefully this research can help us learn from the home birth model”

Lina Zgaga

The researchers from Trinity College Dublin said their findings – published in the journal BMJ Open – may provide important clues to help improve breastfeeding rates.

They said their research involved the largest population cohorts comprehensively examined to date for an association between breastfeeding outcomes and place of birth in low risk pregnancies.

It included over 17,500 women from the UK Millennium Cohort Study and 10,500 women from the Growing Up in Ireland study.

The researchers found home birth was significantly associated with breastfeeding immediately after birth, and with continued breast feeding during the first six months.

Home birth mothers were more likely to exclusively breastfeed for six months – 22% versus 9% – in line with World Health Organization guidelines.

The researchers suggested a number of potential reasons for the stronger association between breastfeeding and home birth.

For example, in a home birth, care is typically midwife-led as opposed to physician-led, with midwives typically receiving more education on lactation.

Multiple health professionals we also more involved in care following hospital birth, which the researchers said potentially provided “unpredictable and inconsistent input” on breastfeeding.

In addition, they noted that home birth could also aid immediate and prolonged skin-to-skin contact post-partum, widely considered to have a positive effect on the initiation of breastfeeding.

Meanwhile, interventions such as forceps or vacuum-assisted delivery that occur more frequently in hospital may be stressful, and stress during birth has been linked to stalled breast feeding.

Similarly, hospital births are associated with greater usage of pain-relieving medications, which can cause lethargy in the infant and delay milk production in the mother, said the researchers.

Lastly, they said previous studies had shown that formula supplementation in the early postnatal period reduced the likelihood of subsequent exclusive breastfeeding and its overall duration.

Trinity College Dublin

Breastfeeding twice as likely after home births than hospital births

Lina Zgaga

Hospital births were associated with formula supplementation, they noted, possibly due to understaffed units finding formula a more convenient solution to feeding problems than diagnosis and treatment of breastfeeding issues.

Senior study author Dr Lina Zgaga, said: “The key question that this work raises is: when breastfeeding is so strongly recommended across the board by the medical profession, what causes lower rates of breastfeeding following hospital births?

“Hopefully this research can help us learn from the home birth model and identify the changes that could be implemented in standard hospital-based perinatal care to encourage and facilitate breastfeeding,” she said.

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Readers' comments (1)

  • I am a great supporter of breastfeeding, but feel we must be realistic about these findings. Surely the reason more women who choose a home birth breast feed is because women who chose a home birth are just more likely to breast feed anyway. I cannot understand why this was not mentioned by the researchers.

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