title: Self-reported reasons for breastfeeding cessation among low-income women enrolled in a peer counseling breastfeeding support program.
abstract: BACKGROUND
  Peer counseling programs have demonstrated efficacy in improving breastfeeding rates in the low-income population, but there is little research concerning why women enrolled in these programs ultimately discontinue breastfeeding.
  
  
  OBJECTIVE
  This study aimed to describe the self-reported reasons for discontinuing breastfeeding among women who are receiving peer counseling support by participant characteristics and timing of discontinuation.
  
  
  METHODS
  This study is a secondary analysis of data collected from 7942 participants who discontinued breastfeeding while enrolled in a peer counseling breastfeeding support program from 2005 to 2011. Reasons for discontinuing breastfeeding were assessed in relation to participant characteristics and weaning age using chi-square analyses and Kruskall-Wallis analyses of variance.
  
  
  RESULTS
  The most common reasons reported for discontinuing breastfeeding were mother's preference (39%) and low milk supply (21%), although reasons differed by age of infant weaning (P < .001). Among participants who discontinued the earliest, the most commonly cited reasons were breastfeeding challenges [median duration (interquartile range), 4.7 (2.0, 13.4) weeks], followed by low milk supply [8.9 (4.6, 19.1) weeks] and mother's preference [12.9 (5.0, 25.7) weeks]. Women who were younger, were less educated, were non-Hispanic black, were unmarried, and had no prior breastfeeding experience were the most likely to discontinue breastfeeding due to mother's preference.
  
  
  CONCLUSIONS
  Peer counselors are in a unique position to offer breastfeeding education and encouragement and may be able to use evidence presented here to anticipate specified concerns either prenatally or postpartum, to prevent early breastfeeding discontinuation.
authors.affiliation: Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
authors.forename: Mary R
authors.initials: MR
authors.lastname: Rozga
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Kerver
authors.affiliation: Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA bholson@wisc.edu.
authors.forename: Beth H
authors.initials: BH
authors.lastname: Olson
mesh_terms: D000328:Adult; D001942:Breast Feeding; D000072117:Counselors; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services; D008824:Michigan; D010352:Patient Dropouts; D010379:Peer Group; D011203:Poverty; D057566:Self Report; D012944:Social Support; D055815:Young Adult
keywords: breastfeeding; low-income; peer counseling