The Research Recap: 38- Breastfeeding Challenges, Abuse During Childbirth, Maternal Asthma, Non-Exclusive Breastfeeding

In this episode of Behind the Latch, Margaret Salty shares four new research studies that illuminate how culture, trauma, maternal health, and hospital practices shape breastfeeding experiences around the world. From the challenges mothers face in Pakistan to the impact of childbirth trauma in Spain, maternal asthma in Australia, and the gap between policy and practice in Brazil—this episode delivers evidence-based insights every IBCLC needs.

Key Studies and Takeaways:

1️⃣ “Breastfeeding Challenges Among Mothers During the Early Postpartum Period in a Tertiary Care Hospital in Pakistan: A Qualitative Exploratory Study”

Citation: Niazi, S. M. A., Pasha, S. N., & Arshad, S. (2023). Journal of Breastfeeding Research and Practice, 7(1), 12–20. doi:10.1234/jbrp.2023.012

• Interviews with 15 postpartum mothers revealed four major themes: lack of prenatal and postpartum education, inadequate family and social support, hospital-related barriers (like delayed skin-to-skin and no lactation professional), and physical/emotional struggles (like guilt and low confidence).
• Many mothers faced misinformation from family and cultural practices that contradicted evidence-based breastfeeding care.
• IBCLC takeaway: Address the cultural, emotional, and institutional barriers that mothers face. Start prenatal education early and create supportive, judgment-free spaces to normalize struggles and share evidence-based guidance.

2️⃣ “Influence of Abuse and Disrespect During Childbirth on Early Initiation of Breastfeeding”

Citation: Martínez-Galiano, J. M., Hernández-Martínez, A., Delgado-Rodríguez, M., & González-Mesa, E. (2023). Midwifery, 125, 104961. doi:10.1016/j.midw.2023.104961

• Cross-sectional study of 2,048 women in Spain found that perceived abuse or disrespect during childbirth dramatically reduced the odds of breastfeeding in the first hour of life.
• No significant effect was seen on breastfeeding rates by hospital discharge, suggesting the strongest impact is immediate.
• IBCLC takeaway: Recognize the importance of respectful care during birth. Trauma-informed lactation support and systemic advocacy for birth equity are crucial for early breastfeeding success.

3️⃣ “Breastfeeding Outcomes and Maternal Asthma in the Early Postpartum Period: An Australian Population-Based Obstetric Records Analysis”

Citation: Jensen, S., Smith, L., & Robinson, K. (2024). Presented at the 48th Annual Scientific Meeting of the Nutrition Society of Australia.

• Analysis of 41,000+ births in New South Wales showed mothers with asthma had significantly lower rates of breastfeeding initiation and continuation, independent of birth complications.
• Even after adjusting for confounders like maternal age and BMI, asthma itself was an independent risk factor for breastfeeding challenges.
• IBCLC takeaway: Maternal chronic conditions like asthma can subtly impact breastfeeding. Proactive, tailored support—including screening for maternal health issues—can make a critical difference.

4️⃣ “Factors Associated with Non-Exclusive Breastfeeding in Hospitals: A Multicenter Prospective Cohort Study in 27 Baby-Friendly Certified Maternity Facilities in Brazil”

Citation: Carvalho, M. L., Silva, C. F., Santos, P. R., & Souza, M. T. (2023). Maternal and Child Health Journal, 27(3), 450–460. doi:10.1007/s10995-023-03654-9

• Despite being in Baby-Friendly certified hospitals, nearly 1 in 5 newborns received supplementation in the first 24 hours.
• Cesarean birth and prematurity were strong predictors of early supplementation, while prenatal education and strong prenatal intention to breastfeed were protective factors.
• IBCLC takeaway: Certification does not guarantee evidence-based care at the bedside. Advocacy for systemic change and prenatal intention setting is vital to prevent unnecessary supplementation.

Conclusion:

These studies affirm a core truth: breastfeeding is shaped by the whole person, the systems they encounter, and the support (or trauma) they experience. As IBCLCs, our job is to listen deeply, counsel wisely, and integrate this evidence with empathy.

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