A NEW STUDY carried out in Trinity College Dublin has found that there is a strong positive relationship between a planned birth at home and breastfeeding.

It found that giving birth at home is significantly associated with breastfeeding immediately after birth, and with continued breastfeeding during the first 6 months.

Homebirth mothers were more likely to exclusively breastfeed for six months – 22% did so, compared to 9% of other mothers.

The study included over 10,500 Irish women and 17,500 women from the UK.

Ireland has significantly lower rates of breastfeeding with only 60% of women starting breastfeeding as against a European norm of around 90%.

This is in spite of World Health Organisation (WHO) guidelines which recommend exclusive breastfeeding for the first six months of life.

Government statistics

Dr Lina Zgaga, the study’s principal researcher said: “The key question that this work raises is – when breastfeeding is so strongly recommended across the board by the medical profession, what causes lower rates of breastfeeding following hospital births?

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Hopefully this research can help us learn from the home birth model and identify the changes that could be implemented in standard hospital-based perinatal care to encourage and facilitate breastfeeding.

The research, the largest such yet carried out, was undertaken by Trinity’s department of public health and primary care.

Published in the leading international journal BMJ Open, it also brought into question some Irish government statistics.

“The self-reported home birth rate we observed for the Irish cohort (1.48%) was similar to the UK rate (2%), but more than seven times the rate reported in Irish government-published data (0.2%),” said Dr Clare Quigley, the main analyst of the study.

The government data may report a lower rate as it includes only planned home births that were attended to by an independent midwife, but excludes home births that took place as part of hospital-administered home birth schemes.

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Better with midwives

The study’s researchers suggest a number of potential reasons for the stronger association between breastfeeding and home birth:

• In a home birth, the mother is supported by the same midwife throughout the first two weeks, whereas multiple health professionals in a hospital birth can provide inconsistent input.
• In a home birth, care is typically led by a midwife, who generally receive more training in relation to lactation that hospital physicians
• A home birth also allows more skin to skin contact after birth, widely considered to have a positive effect on breastfeeding and bonding.

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Forceps and painkillers

The study also found that

• Stressful interventions such as forceps or vacuum-assisted delivery occur more frequently during labour in hospital, stalling breast feeding.
• Hospital births are also associated with greater usage of painkillers, which can cause lethargy in the infant and delay milk production in the mother.
• Formula supplementation, which often happens in Irish hospitals, in the early postnatal period reduces the likelihood of subsequent exclusive breastfeeding and overall duration of breastfeeding,

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