Pediatric Care Providers, Family, and Friends as Sources of Breastfeeding Support Beyond Infancy

Objective: To examine women's perceptions about support from pediatric primary care providers (PCPs), family, and friends for breastfeeding beyond 12 months, which is an increasing common practice. Study Design: Women who breastfed at least one child beyond 12 months completed an online questionnaire distributed via La Leche League USA (2013). Questionnaire content focused on sources of support for breastfeeding beyond 12 months, support ratings, and participant characteristics. Bivariate statistics and multivariable log-binomial regression compared ratings of support across sources, by PCP sex, and with breastfeeding duration. Results: Of 48,379 eligible U.S. women, about half discussed their decision to breastfeed beyond infancy with their child's PCP. In contrast, almost all (91.4%) did so with their spouse, partner, or significant other. Women were consistently more comfortable discussing their decision to breastfeed for more than a year with their family and closest friend than they were with their child's PCP (all p<0.001). Three-fourths of PCPs were rated as supportive, but 11.1% were somewhat or very unsupportive. Female pediatricians received similar ratings as males (adjusted risk ratio=1.01, 95% confidence interval: 1.00, 1.03). Thirty-eight percent of women who reported their PCP was unsupportive changed PCPs. Conclusion: Family and PCP support is likely to be important for the growing proportion of U.S. mother-child dyads who are breastfeeding beyond 12 months. Many, but not all, women rated their child's PCP as supportive, and lack of support was a reason women reported for changing PCPs. Evidence-based interventions in primary care to support breastfeeding beyond infancy are needed.