Women who live in households that have trouble putting food on the table tend to stop breastfeeding earlier than others, according to a new study.
The study, published in the Canadian Medical Association Journal on Monday, found that Canadian women who reported food insecurity – meaning that they worried about affording enough food to feed their families or ate less to save money – only exclusively breastfed their infants about half as long as women who weren’t worried about affording food.
The study examined 10,450 women who responded to a Statistics Canada survey. Seventeen per cent of women surveyed reported some measure of food insecurity.
Half of women who reported food insecurity stopped exclusive breastfeeding after two months. It took four months before half of the other women did the same.
This could have serious implications for the infants’ health, notes the study. “The earlier cessation of exclusive breastfeeding by women in food-insecure households means that their infants are less likely to reap the physical and emotional health benefits of breastfeeding,” it reads.
The World Health Organization recommends that infants breastfeed exclusively for six months “to achieve optimal growth, development and health.”
Stopping breastfeeding earlier also has economic implications, said study co-author Valerie Tarasuk, professor in the department of nutritional sciences at the University of Toronto. “When somebody stops exclusive breastfeeding, they have to be able to feed their infant another way, and infant formula is very expensive.”
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“Somebody who is struggling to put food on the table can ill-afford formula. That’s the tragedy of this.”
She notes that food insecurity is an even stronger measure of poverty than just income. “By the time somebody tells you they’re struggling to put food on the table because they can’t afford it, what you’re seeing is a mixture of their income and their assets and their expenses.”
Switching to formula
Mothers don’t decide to stop breastfeeding because they’re ignorant of its benefits, said Tarasuk. The survey found that almost all the women started to breastfeed, no matter their food security status.
“Everyone recognized the importance of breastfeeding and tried to do it. But the women in food-insecure situations were less able to sustain the practice.”
Previous research by study co-author Lesley Frank, an associate professor of sociology at Acadia University, provides some hints as to why.
“It seems somewhat counterintuitive that a mother that is food-insecure would ever bottle-feed,” said Frank. Breastfeeding isn’t just the healthy option, she said, it’s often thought of as the affordable option. “We perceive breast milk to be free.”
But yet many food-insecure women switch away from it.
In Frank’s interviews with women, many said they worried that they didn’t have enough milk or that the milk they produced wasn’t “healthy enough” when they hardly ate themselves, she said.
“They’re so concerned about the nutrition of the baby and thinking that the baby’s hungry and that the baby’s not being fed properly because their breast milk is not adequate, that they stop.”
Women feel that they can’t count on their own bodies to produce enough food, so they choose to buy formula, she said. So often they shift the family’s limited resources to buy formula first and rely on food banks or other charities to fill in the gaps for the rest of the family’s food since formula is harder to find there.
Women in food-insecure households are in a very stressful situation, said Tarasuk, which contributes to their decision to stop breastfeeding.
“They’re struggling to feed themselves well, to look after whoever else is in their family. If people are struggling to put food on the table, they’re often also struggling to pay their rent or other bills,” she said.
Most Canadian women don’t meet the WHO recommendations for exclusive breastfeeding, she said, so it’s not surprising that women in poverty also don’t. “It takes a very supportive environment I think for women to maintain breastfeeding for that length of time.”
“They’re doing what they’re supposed to do as best they can. But they’re just not able to sustain what is even for an advantaged woman a difficult behaviour to maintain.”
She hopes that policy-makers take notice of the study’s findings.
“That’s ridiculous that we have that many women who have just given birth in situations where they’re struggling and then that we see such a palpable impact on something as fundamental as infant-feeding practices within the first two months of children’s lives.”
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