Why primiparous mothers do not breastfeed in the United States: a national survey

Aim: To investigate primiparous women's primary reason for not breastfeeding. Methods: We used the 1995 National Survey of Family Growth to analyze the breastfeeding behaviors of a national probability sample of 6733 first-time US mothers, aged 15 to 44 y. Main outcome measures in this cross-sectional study were the reasons for never breastfeeding and reasons for stopping breastfeeding using closed-ended, multiple choice questions. Results: Most commonly, women did not breastfeed because they "preferred to bottle feed" (66.3%). The most common reason for stopping breastfeeding was that the child was "old enough to wean" (35.7%), although 15%, 34%, 54%, and 78% of those women had stopped breastfeeding by 3, 6, 9, and 12 mo, respectively. "Physical or medical problem" was reported by 14.9% of women who did not breastfeed and 26.9% of women who had stopped breastfeeding, making it the second most common reason for not breastfeeding in each group. There were significant differences across racial and ethnic groups. Conclusion: Additional studies are needed to better understand why women "prefer to bottle feed", especially black women. Increasingly effective programs and policies to promote breastfeeding will logically follow. Since physical and medical problems are such common reasons both for never breastfeeding and for stopping breastfeeding, individual healthcare providers can have a significant impact on breastfeeding rates and duration.