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Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.d8287 (Published 25 January 2012) Cite this as: BMJ 2012;344:d8287

Re: Systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing

Dear editor,

In response to a systematic review of peer support for breastfeeding continuation: metaregression analysis of the effect of setting, intensity, and timing by Jolly et al., 2012. I wish to provide my perspective on breastfeeding continuation from a different angle. Breastfeeding according to World Health Organization (WHO) (2016) is considered to be the normal way of providing nutrients to newborn and infants. They also recommend that exclusive breastfeeding be done up to six (6) months old, not inclusive of water, juice or anything but the breast milk, however oftentimes the perception of the mothers are not taken into consideration.

From my experience as a first time mother breastfeeding is not as easy as it looks especially if the baby is not latching on properly; which may result in sore nipples, which is painful and stressful which aides in the discontinuation of breastfeeding before the recommended time. Then this mother is also adjusting to the other challenges of motherhood and making the process even worst is the limited amount of time the mother has at home with her child because the mother has to return to work.

In Jamaica exclusive breastfeeding for 6 months is also recommended, however the laws of the country do not allow/ accommodate for a working mother to breastfeed exclusively. The maternity act allows a mother to be entitled to only 12 weeks of paid maternity leave and an optional maximum of 12 weeks unpaid leave which both are inclusive of weekends and public holidays (Ministry of Justice, 1979). However, how many mothers can afford the optional additional 12 weeks unpaid maternity leave off? Within a middle income earning country such as Jamaica most mothers are unable to take up this offer, which results in a mother typically getting 2 ½ to 3 months at home with her newborn child, this therefore means that most times exclusive breastfeeding usually ends when she returns to work.

Now, one would say the mother can express her breast milk at work to facilitate the continuation of breastfeeding. However most workplaces do not provide facilities for a mother to relax and be able to express her milk privately. Hence a mother may have to resort to a bathroom to express her milk, which is not only unsanitary but extremely uncomfortable. Therefore for the continuation of breastfeeding a mother not only needs support from her family and peers but also from her place of work.

References
Ministry of Justice. (1979). Maternity Leave Act. Government of Jamaica. Retrieved from, http://moj.gov.jm/laws/maternity-leave-act on June 9, 2016.
World Health Organization. (2016). Breastfeeding. Retrieved from http://www.who.int/topics/breastfeeding/en/ on June 9, 2016.

Competing interests: No competing interests

13 June 2016
Kadiann P Hewitt-Thompson
Nurse Educator
Sanesha Mitchell
The UWI School of Nursing
9 Gibraltar Camp Way, Mona, Kingston