How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study

Abstract Background Despite the health benefits of breastfeeding only 57% of infants were exclusively breastfed at 4 months postpartum in Germany in 2017–2019. Due to the gap between the actual exclusive breastfeeding (EBF) rates and recommendations, we aimed at investigating further factors influen...

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Main Authors: Theresa Philomena Ertlmaier, Oana Costea, Anja Borgmann-Staudt, Monika Berns, Georg Weikert, Mathilde Kersting, Magdalena Balcerek
Format: Article
Language:English
Published: BMC 2025-05-01
Series:International Breastfeeding Journal
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Online Access:https://doi.org/10.1186/s13006-025-00726-4
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author Theresa Philomena Ertlmaier
Oana Costea
Anja Borgmann-Staudt
Monika Berns
Georg Weikert
Mathilde Kersting
Magdalena Balcerek
author_facet Theresa Philomena Ertlmaier
Oana Costea
Anja Borgmann-Staudt
Monika Berns
Georg Weikert
Mathilde Kersting
Magdalena Balcerek
author_sort Theresa Philomena Ertlmaier
collection DOAJ
description Abstract Background Despite the health benefits of breastfeeding only 57% of infants were exclusively breastfed at 4 months postpartum in Germany in 2017–2019. Due to the gap between the actual exclusive breastfeeding (EBF) rates and recommendations, we aimed at investigating further factors influencing breastfeeding duration. Methods This prospective observational study conducted in Berlin, Germany from 11/2022–05/2024 implemented a mixed-methods design with concurrent triangulation. We present quantitative results here. First-time mothers were surveyed at birth and 2, 6 and 12 months postpartum. Breastfeeding status was assessed by asking “How are you currently feeding your child?” and, if anything other than EBF (defined as supply of breastmilk without liquids or solids) was indicated, “I breastfed exclusively until [date]”. Maternal perception was assessed by asking “How comfortable do you currently feel with breastfeeding/feeding your child?”, with comfort referring to well-being/statisfaction/feeling good (German = wohlfühlen). Obstetric and newborn characteristics were collected from recruiting hospital’s health records: an anthroposophic baby-friendly certified hospital (a-BF), a baby-friendly certified hospital (BF) and a university hospital not certified as baby-friendly (non-BF). Data were analysed descriptively and through multivariate analysis. Results Most of the 326 participating mothers had initiated breastfeeding in the delivery room (94.7%). Mothers reported EBF for a median duration of 5.7 months, with 76.6% achieving ≥ 4 months. High levels of maternal comfort with breastfeeding 2 months postpartum were significantly associated with an EBF duration ≥ 4 months (aOR 7.25, CI 95% 2.11, 24.9). An intended EBF duration of 4–7 months (aOR 4.08, CI 95% 0.29, 57.77), higher breastfeeding comfort shortly after birth (aOR 1.79, CI 95% 0.49, 6.59), delivery in the a-BF clinic (aOR 1.59, CI 95% 0.41, 6.14) and high satisfaction regarding breastfeeding support in the hospital (aOR 1.39, CI 95% 0.41, 4.70) increased likeliness of EBF ≥ 4 months. Conclusion Our results emphasize the pivotal role of the mother’s comfort in the breastfeeding process and it’s impact on breastfeeding duration. Strategies to enhace maternal comfort therefore need to be specifically included in maternal care. To explore key aspects of maternal comfort qualitative interviews will address the individual experiences in the breastfeeding journey and identify parent-centred strategies for sustainable breastfeeding.
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spelling doaj-art-d086b08bb55740a6a22002bb3c72d3022025-08-20T03:53:57ZengBMCInternational Breastfeeding Journal1746-43582025-05-0120111210.1186/s13006-025-00726-4How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods studyTheresa Philomena Ertlmaier0Oana Costea1Anja Borgmann-Staudt2Monika Berns3Georg Weikert4Mathilde Kersting5Magdalena Balcerek6Department of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt Universität Zu BerlinDepartment of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt Universität Zu BerlinDepartment of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt Universität Zu BerlinDepartment of Neonatology, Charité-Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt Universität Zu BerlinDepartment of Gynaecology and Obstetrics, Gemeinschaftskrankenhaus HavelhöheResearch Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-UniversityDepartment of Pediatric Oncology and Hematology, Charité-Universitätsmedizin Berlin, corporate member of, Freie Universität Berlin and Humboldt Universität Zu BerlinAbstract Background Despite the health benefits of breastfeeding only 57% of infants were exclusively breastfed at 4 months postpartum in Germany in 2017–2019. Due to the gap between the actual exclusive breastfeeding (EBF) rates and recommendations, we aimed at investigating further factors influencing breastfeeding duration. Methods This prospective observational study conducted in Berlin, Germany from 11/2022–05/2024 implemented a mixed-methods design with concurrent triangulation. We present quantitative results here. First-time mothers were surveyed at birth and 2, 6 and 12 months postpartum. Breastfeeding status was assessed by asking “How are you currently feeding your child?” and, if anything other than EBF (defined as supply of breastmilk without liquids or solids) was indicated, “I breastfed exclusively until [date]”. Maternal perception was assessed by asking “How comfortable do you currently feel with breastfeeding/feeding your child?”, with comfort referring to well-being/statisfaction/feeling good (German = wohlfühlen). Obstetric and newborn characteristics were collected from recruiting hospital’s health records: an anthroposophic baby-friendly certified hospital (a-BF), a baby-friendly certified hospital (BF) and a university hospital not certified as baby-friendly (non-BF). Data were analysed descriptively and through multivariate analysis. Results Most of the 326 participating mothers had initiated breastfeeding in the delivery room (94.7%). Mothers reported EBF for a median duration of 5.7 months, with 76.6% achieving ≥ 4 months. High levels of maternal comfort with breastfeeding 2 months postpartum were significantly associated with an EBF duration ≥ 4 months (aOR 7.25, CI 95% 2.11, 24.9). An intended EBF duration of 4–7 months (aOR 4.08, CI 95% 0.29, 57.77), higher breastfeeding comfort shortly after birth (aOR 1.79, CI 95% 0.49, 6.59), delivery in the a-BF clinic (aOR 1.59, CI 95% 0.41, 6.14) and high satisfaction regarding breastfeeding support in the hospital (aOR 1.39, CI 95% 0.41, 4.70) increased likeliness of EBF ≥ 4 months. Conclusion Our results emphasize the pivotal role of the mother’s comfort in the breastfeeding process and it’s impact on breastfeeding duration. Strategies to enhace maternal comfort therefore need to be specifically included in maternal care. To explore key aspects of maternal comfort qualitative interviews will address the individual experiences in the breastfeeding journey and identify parent-centred strategies for sustainable breastfeeding.https://doi.org/10.1186/s13006-025-00726-4BreastfeedingDurationInfluencing factorsMaternal comfortBaby-friendly hospitalAnthroposophy
spellingShingle Theresa Philomena Ertlmaier
Oana Costea
Anja Borgmann-Staudt
Monika Berns
Georg Weikert
Mathilde Kersting
Magdalena Balcerek
How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
International Breastfeeding Journal
Breastfeeding
Duration
Influencing factors
Maternal comfort
Baby-friendly hospital
Anthroposophy
title How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
title_full How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
title_fullStr How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
title_full_unstemmed How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
title_short How can we support the individual breastfeeding experience? Quantitative results from a mixed-methods study
title_sort how can we support the individual breastfeeding experience quantitative results from a mixed methods study
topic Breastfeeding
Duration
Influencing factors
Maternal comfort
Baby-friendly hospital
Anthroposophy
url https://doi.org/10.1186/s13006-025-00726-4
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