Breastfeeding twice as likely after home birth

Mothers are twice as likely to breastfeed after a home birth than a hospital one, it has emerged.

Twenty-two percent of home birth mothers exclusively breastfeed for six months — compared to 9% of other mothers.

Ireland has significantly lower rates of breastfeeding, with only 60% of women starting breastfeeding, compared to the European norm of around 90%.

Exclusive breastfeeding is recommended up to six months of age by the World Health Organisation.

Researchers at Trinity College Dublin-based their finding on collected data and an analysis of factors surrounding home and hospital-based births.

The study’s principal researcher, Dr Linda Zgaga, said the information might help to improve low breastfeeding rates in Ireland by identifying the changes that could be implemented in the hospital setting to encourage and facilitate breastfeeding.

Dr Zgaga, associate professor of epidemiology at TCD said the work also raises a fundamental question about breastfeeding in Ireland.

“When breastfeeding is so strongly recommended across the board by the medical profession, what causes lower rates of breastfeeding following hospital births?” she asked.

The research suggested a number of potential reasons for higher home birth breastfeeding rates.

  • A home birth is typically midwife-led and in Ireland a self-employed community midwife is the mother and child’s primary carer until the baby is 14 days old;
  • Many health professionals are involved after a hospital birth, potentially providing unpredictable and inconsistent input;
  • Support in the days after birth improves outcomes for the mother and baby but some mothers do not get it as soon as they should;
  • There is shared care between the obstetricians and GP in hospital births, followed by a visit from a public health nurse that should take place within 48 hours of discharge. However, the percentage of first visits achieved varied significantly from 57% to 87%;
  • Also, the non-clinical setting of a home allows immediate and prolonged skin to skin contact between mother and baby after birth — widely considered to have a positive effect on the initiation of breastfeeding and mother-infant bonding.

The study, published in the international journal BMJ Open, also noted the increased use of interventions, assisted delivery, and pain relief in hospitals compared to home births.

Despite all maternity units participating in an initiative that recommends that newborns should not receive any food or drink other than breast milk unless medically indicated, hospital births have been associated with formula supplementation.

“This may be due to busy, understaffed clinical settings, where formula feeding may be found to be a more convenient solution to feeding problems than diagnosis and treatment of breastfeeding issues,” the study suggests.

The study, the largest of its kind, used more than 10,500 women from Growing Up in Ireland and 17,500 women from the UK Millennium Cohort.

The self-reported home birth rate in Ireland, at 1.48%, is similar the British rate of 2%.

The study notes that the official Government figure for homebirths in Ireland is only 0.2% as it only records planned home births attended by an independent midwife and excludes hospital-administered home births.


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