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Breastfeeding twice as likely after a home birth, research finds

Published 10/08/2016

Mothers who have a home birth are more likely to go on to breastfeed, research has found
Mothers who have a home birth are more likely to go on to breastfeed, research has found

Women who give birth at home are twice as likely to breastfeed as other new mothers, researchers have found.

Academics at Trinity College Dublin said their studies show home birth is significantly associated with immediate breastfeeding and mothers continuing it into the baby's first six months.

They also found mothers who give birth at home are more likely to exclusively breastfeed for the first 24 weeks - 22% compared with 9% of other mothers.

Lina Zgaga, associate professor of epidemiology at Trinity, said the information may help to improve low breastfeeding rates in Ireland.

She 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."

About 60% of mothers start breastfeeding in Ireland compared to a European norm of about 90%. World Health Organisation guidelines recommend exclusive breastfeeding for a baby's first six months.

The research identified potential reasons for the higher breastfeeding rates.

It noted that home birth has different support and care and is typically midwife-led.

It said the same community midwife should be visiting and advising the mother for the first 14 days of a baby's life, compared to a hospital where there are many different medics who, it warned, are " potentially providing unpredictable and inconsistent input".

Researchers said support in the days after birth improve outcomes for mother and baby but they warned that the percentage of first visits after a mother is discharged from hospital varies significantly from 57% to 87%.

It also pointed to a mother's home being non-clinical, promoting immediate and prolonged skin to skin contact between mother and baby immediately after birth , which is widely considered to have a positive effect on the initiation of breastfeeding and mother-infant bonding.

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

And it said hospital births have been associated with formula supplementation despite all maternity units being part of an initiative which recommends that newborns should not receive any food or drink other than breast milk unless medically indicated

The study said this may be due to busy, understaffed clinical settings, where formula may be a more convenient solution to feeding problems than diagnosis and treatment of breastfeeding issues.

The study from Trinity's Department of Public Health and Primary Care is the largest of its kind, using more than 10,500 women from Growing Up in Ireland and 17,500 women from the UK Millennium Cohort. It was published in the international journal BMJ Open.

The data revealed a self-reported home birth rate of 1.48% in Ireland compared to 2% in the UK.

The official figure used by the government is 0.2% which only includes planned home births attended to by an independent midwife.

Another study coinciding with World Breastfeeding Week showed women who give birth in a midwife-only unit are 30% more likely to breastfeed than those in traditional wards.

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