Aids and Breastfeeding

Introduction

Research on the psychological aspects of breastfeeding has tended to focus on one of two issues: (i) the factors that determine parental choice of infant feeding method, or (ii) the consequences of breastfeeding for the child's psychological development. This chapter will summarize the conclusions that can be drawn from research on these two issues.

Parental attitudes to and social and professional support for breastfeeding

Although the last two decades of the twentieth century witnessed an increase in the number of mothers who initiated breastfeeding, as compared with the steady decline seen during the earlier decades of the century, most mothers wean before the recommended age of six months postpartum because of perceived difficulties in breastfeeding (see Dennis, 2002). An illustrative example comes from research by Heath et al. (2002): although 88% of a self-selected sample of New Zealand mothers participating in this study initiated breastfeeding, only 42% were exclusively breastfeeding at three months (White, pp. 136).

In industrialized countries there are clear demographic differences between women who do and who do not breastfeed. Women least likely to breastfeed tend to be younger, to have lower incomes, to be from an ethnic minority, to receive less support for breastfeeding, to be employed full-time and to have more negative attitudes to breastfeeding and less confidence in their ability to breastfeed. Two sets of findings are especially noteworthy. First, there is an abundance of evidence that parental attitudes to and beliefs about breastfeeding are strongly associated with a woman's decision to breastfeed or with the duration of breastfeeding. Secondly, the degree of support a woman receives from professionals and laypersons has an impact on her breastfeeding decisions and behaviors (Shaw & Bartlett, pp. 145).

With regard to the relation between attitudes and decision to breastfeed, Manstead et al. (1983) found that attitudes as measured in the last trimester of pregnancy were strongly predictive of whether mothers chose to feed by breast or by bottle during the first six weeks of the baby's life. Mothers who breastfed during these six weeks were significantly more likely than bottlefeeding mothers to believe that breastfeeding provides better nourishment for the baby, is good for the mother's figure, protects the baby against infection, and establishes a close bond between mother and baby. Mothers who bottlefed during the first six weeks were significantly more likely than breastfeeding mothers to believe that bottlefeeding is convenient, is trouble-free and makes it possible for the baby's father to be involved in feeding. Because these beliefs and attitudes were assessed antenatally in a large sample of primiparous women, and were related to postnatal behaviours, it is reasonable to interpret the observed associations as reflecting the causal impact of beliefs on behaviours. Recent research confirmed the importance of maternal beliefs and attitudes but also showed that the father's attitudes and beliefs were associated with the decision to breastfeed or bottlefeed.

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