Breastfeeding Outcomes,Self-Efficacy,and Satisfaction Among Low-Income Women With Late-Preterm,Early-Term,and Full-Term Infants

ObjectiveTo assess breastfeeding exclusivity and rate of breastfeeding, breastfeeding self-efficacy, and satisfaction with breastfeeding after hospital discharge among low-income women with late-preterm and early-term infants compared with women with full-term infants.DesignProspective, comparative, with repeated measures.SettingFour Midwestern U.S. Special Supplemental Nutrition Program for Women, Infants, and Children offices.ParticipantsParticipants included 270 mother–infant dyads.MethodsWe assessed breastfeeding exclusivity, rate of breastfeeding, and breastfeeding self-efficacy at 2 weeks, 2 months, and 5 months and satisfaction with breastfeeding at 5 months after birth or when participants stopped breastfeeding.ResultsMore than 50% of women in each subgroup were non-Hispanic White. Late-preterm and early-term infants had lower breastfeeding exclusivity rates than full-term infants across the three time points (40%, 51%, and 65% at 2 weeks, p = .029; 22.5%, 34%, and 58% at 2 months, p < .001; and 7%, 15%, and 28.46% at 5 months, p < .001, respectively). The overall exclusive breastfeeding rate for all groups was 55.93% at 2 weeks, 44.07% at 2 months, and 20.37% at 5 months; 55.56% continued any breastfeeding at 5 months. Breastfeeding self-efficacy during the first 5 months after birth, satisfaction with breastfeeding, level of education, and attending breastfeeding classes were positively correlated with breastfeeding exclusivity. We found significantly less exclusive breastfeeding, lower breastfeeding self-efficacy, and lower satisfaction with breastfeeding among participants with late-preterm and early-term infants compared to those with full-term infants.ConclusionOngoing professional breastfeeding support for women is needed to improve and promote breastfeeding exclusivity and continuation among their late-preterm and early-term infants.     

Scoping Review of Postpartum Discharge Education Provided by Nurses

ObjectiveTo determine what is known about postpartum education provided by nurses to women before discharge from the hospital after birth and whether current nursing practices are effective to prepare women to identify warning signs of complications, perform self-care (physical and emotional), prepare for parenting a newborn, and establish infant feeding.Data SourcesWe conducted a systematic search of CINAHL Plus and MEDLINE for relevant sources, including peer-reviewed articles, conference presentations, and guidelines from professional organizations, that were published in English from January 2010 through November 30, 2020.Study SelectionWe included sources if participants were women who had given birth to a healthy, liveborn, term infant and were receiving education in whole or in part by a nurse during the maternity hospitalization. We excluded sources with samples of high-risk women or those who gave birth to high-risk infants (preterm, congenital anomalies, neonatal abstinence syndrome). Forty-six of the sources met the inclusion criteria.Data ExtractionWe extracted citation, type of document, country of origin, context (prenatal/postpartum or both and inpatient/outpatient or both), aim, participants (mother/father or both, sample characteristics), content of education and who provided it, outcomes or key themes, and main results.Data SynthesisInfant topics included breastfeeding and safe sleep, and maternal topics included breastfeeding, postpartum mood, and self-care after birth. Nurses prioritized safety, including safe sleep; preventing infant falls; decreasing infection; screening for postpartum depression; and avoiding adverse outcomes after discharge. Women focused on self-care, pain management, infant care, and parenting. Women and nurses prioritized breastfeeding. Authors of the included sources measured effectiveness by patient satisfaction, chart audit, pre- and posttests of nurses’ knowledge, and breastfeeding duration. Women reported barriers to postpartum education such as limited nursing time or conflicting information.ConclusionPostpartum education is a priority, but its effectiveness is not well studied. Few maternal or infant health–centered outcomes have been measured beyond breastfeeding duration. Nursing care and nurse expertise are not easily quantified or measured. Research is needed to inform best practices for postpartum education.     

Integrative Review of Antenatal Milk Expression and Mother–Infant Outcomes During the First 2 Weeks After Birth

ObjectiveTo explore the practice of antenatal milk expression (AME) and related outcomes for mother–infant dyads during the first 2 weeks after birth.Data SourcesWe searched the electronic databases MEDLINE, Embase, CINAHL, Emcare, Maternity & Infant Care Database, Scopus, and Web of Science for relevant literature. We also conducted backward reference searches on relevant publications and nondatabase searches after review of the full texts.Study SelectionArticles were eligible for inclusion if they reported primary studies focused on AME, included samples of mother–infant dyads, and were published in English. We did not impose time or design limitations given the sparse availability of literature on AME. We identified 766 articles. After the removal of duplicates, we screened 588 articles, and of these, we included 15 articles in our review.Data ExtractionWe used the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines to guide data extraction and reporting. We evaluated the quality of evidence using the Melnyk and Fineout-Overholt rating system and the Joanna Briggs Institute critical appraisal tools.Data SynthesisWe synthesized data from the included articles into four themes: Breastfeeding Self-Efficacy, Milk Supply, Infant Well-Being, and Infant Feeding Methods.ConclusionAME may support breastfeeding by improving breastfeeding self-efficacy and milk supply and by decreasing early formula use. Synthesized literature on AME shows the safety of the practice and that infants of women who practice AME have a greater likelihood of breastfeeding exclusivity during the short term.     

Effects of Delayed Newborn Bathing on Breastfeeding,Hypothermia, and Hypoglycemia

ObjectiveTo determine whether delaying the newborn bath by 24 hours increases the prevalence of breastfeeding initiation and exclusive breastfeeding at discharge in healthy full-term and late preterm newborns (34 0/7–36 6/7 weeks gestation) and to examine the effect of delayed newborn bathing on the incidences of hypothermia and hypoglycemia.DesignPre–post implementation, retrospective, cohort study.SettingProvincial children’s hospital with an average of 2,500 births per year.ParticipantsHealthy newborns (N = 1,225) born at 34 0/7 weeks or more gestation who were admitted to the mother–baby unit.MethodsWe compared newborns who were bathed before 24 hours (n = 680, preimplementation group) to newborns who were bathed after 24 hours (n = 545, postimplementation group).ResultsAfter adjustment for confounders, the odds of exclusive breastfeeding at discharge were 33% greater in the postimplementation group than in the preimplementation group (adjusted odds ratio = 1.334; 95% confidence interval [1.049,1.698]; p = .019). Delayed bathing was associated with decreased incidence of hypothermia and hypoglycemia (p = .007 and p = .003, respectively). We observed no difference in breastfeeding initiation between groups.ConclusionDelaying the newborn bath for 24 hours was associated with an increased likelihood of exclusive breastfeeding at discharge and a decreased incidence of hypothermia and hypoglycemia in healthy newborns. The implementation of a delayed bathing policy has the potential to improve breastfeeding rates and reduce the incidence of hypothermia and hypoglycemia.     

Randomized Controlled Trial of Motivational Interviewing to Support Breastfeeding Among Appalachian Women

ObjectiveTo determine the effectiveness of a single session of prenatal motivational interviewing (MI) to enhance breastfeeding outcomes.DesignA randomized controlled trial with two groups (MI and psychoeducation) with repeated measures: preintervention, postintervention, and at 1 month postpartum.SettingThe intervention was conducted at a university-associated clinic, community locations, and participants’ homes. Postpartum follow-up was conducted by telephone.ParticipantsA total of 81 women with low-risk pregnancies enrolled at 28 to 39 weeks gestation who lived in Appalachia.MethodsParticipants were randomly assigned to MI or psychoeducation on infant development. Pre- and postintervention outcome measures included intention to breastfeed, confidence in and importance of breastfeeding plan, and breastfeeding attitudes. At 1 month postpartum, participants completed a telephone interview to assess actual breastfeeding initiation, exclusivity, and plans to continue breastfeeding.ResultsAt 1 month postpartum, women in the MI group were more likely to report any current breastfeeding than women in the psychoeducation group, regardless of parity, χ²(1, N = 79) = 4.30, p = .040, Φ = .233. At the postintervention time point, the MI intervention had a significant effect on improving attitudes about breastfeeding among primiparous women only (p < .05).ConclusionOne session of MI was effective to promote breastfeeding at 1 month postpartum and to enhance positive attitudes toward breastfeeding among primiparous women in Appalachia.     

The influence of maternal life stressors on breastfeeding outcomes: a US population-based study

Objective: The purpose of this study was to examine the contribution of maternal financial, emotional, traumatic, and partner-associated stressors on breastfeeding initiation and duration.

Methods: Data (216,756 records) from the Pregnancy Risk Assessment Monitoring System surveys were used in the analysis. Logistic regressions were conducted to estimate the magnitude and direction of associations between maternal stressors occurring in the 12 months prior to infant birth and both breastfeeding initiation and duration up to 4 weeks infant age.

Results: A substantial proportion of mothers (42%) reported having experienced one or two major stressors during the 12 months prior to the birth of their infant. Mothers who reported at least one major life stressor in the year before their baby was born were less likely to initiate breastfeeding and more likely to cease by 4 weeks infant age. Emotional and traumatic stressors were found to have the greatest impact on breastfeeding outcomes.

Conclusions: Findings support the design and implementation of screening protocols for major maternal life stressors during regularly scheduled prenatal and newborn visits. Screening for at-risk mothers may lead to more targeted anticipatory guidance and referral with positive effects on breastfeeding outcomes and overall well-being of the mothers and their families.     

Influence of the Quality of Antenatal Care on Early Breastfeeding Initiation and Exclusive Breastfeeding Among Haitian Women

ObjectiveTo assess the influence of the quality of antenatal care on early breastfeeding initiation and exclusive breastfeeding among Haitian women.DesignSecondary analysis of a cross-sectional household survey.SettingHaiti Demographic and Health Survey, 2016 to 2017.ParticipantsWomen (N = 2,489) who were 15 to 49 years of age with children younger than 24 months of age.MethodsWe used multivariable adjusted logistic regression analysis to examine the independent associations between quality of antenatal care and early breastfeeding initiation and exclusive breastfeeding.ResultsThe prevalence of early breastfeeding initiation and exclusive breastfeeding were 47.7% and 39.9%, respectively. Approximately 76.0% of the participants received intermediate antenatal care. The odds of early breastfeeding initiation were greater among participants who received antenatal care of intermediate quality than among those who did not receive antenatal care, adjusted OR (AOR) = 1.58, 95% confidence interval (CI) [1.13, 2.20]. Additionally, maternal age of 35 to 49 years (AOR = 1.53, 95% CI [1.10, 2.12]) was positively associated with early breastfeeding initiation. Factors negatively associated with early breastfeeding initiation were cesarean birth (AOR = 0.23, 95% CI [0.12, 0.42]), birth at home (AOR = 0.75, 95% CI [0.34, 0.96]), and birth in a private facility (AOR = 0.57, 95% CI [0.34, 0.96]). Factors negatively associated with exclusive breastfeeding were employment (AOR = 0.57, 95% CI [0.36, 0.90]) and birth in a private facility (AOR = 0.21, 95% CI [0.08, 0.52]).ConclusionAntenatal care of intermediate quality was positively associated with early breastfeeding initiation among women in Haiti, which highlights the influence that care during pregnancy can have on breastfeeding outcomes.     

Early Postpartum Patterns of Breastfeeding Exclusivity and Perceived Insufficient Milk by Prepregnancy Body Mass Index

ObjectiveTo explore trajectories of breastfeeding exclusivity and perceived insufficient milk (PIM) over the first 8 weeks postpartum among primiparous women and the association of these trajectories with prepregnancy body mass index (BMI).DesignSecondary analysis of data from a randomized controlled trial.SettingRecruitment for the primary study was conducted in Pittsburgh, Pennsylvania.ParticipantsOne hundred twenty-two primiparous women with intention to exclusively breastfeed.MethodsWe used group-based trajectory modeling to classify participants into breastfeeding exclusivity and PIM trajectory groups. We used logistic regression to explore the predictive relationship between prepregnancy BMI and breastfeeding exclusivity and PIM trajectory group memberships.ResultsWe identified two trajectories each for breastfeeding exclusivity and PIM over the first 8 weeks postpartum. For breastfeeding exclusivity, one group (n = 60, 49%) had low initial probability of exclusive breastfeeding with linear decline in likelihood of exclusivity over time. The other group (n = 62, 51%) had greater initial probability of exclusive breastfeeding, which remained constant over time. For PIM, one group (n = 41, 34%) had consistently greater probability of endorsing PIM at each time point, whereas the other group (n = 81, 66%) had consistently low probability of endorsing PIM over time. Prepregnancy BMI did not predict group membership in breastfeeding exclusivity, χ²(1) = 2.8, p = .094, or PIM, χ²(1) = 0.72, p = .397.ConclusionBreastfeeding exclusivity and PIM appeared to be relatively stable phenomena in the postpartum period among a sample of predominately White primiparous women who intended to breastfeed. We did not find a clear association with prepregnancy BMI.     

An Institutional Ethnography of Nurses’ Support of Breastfeeding on the Night Shift

ObjectiveTo describe nurses’ support of breastfeeding on the night shift and to identify the interpersonal interactions and institutional structures that affect this support.DesignInstitutional ethnography.SettingThe mother/baby unit of a tertiary care hospital with 4200 births per year.ParticipantsRegistered nurses (N = 16) who provided care on the night shift to mother/infant dyads in the immediate postpartum period.MethodsData were collected using focus groups, individual and group interviews, and mother/baby unit observations. The focus groups were held before the night shift and had five participants. The nine individual and group interviews were conducted between 0100 and 0230 on the mother/baby unit. Three unit observations were conducted. Interviews were recorded, professionally transcribed, and analyzed using a content analysis method.ResultsData analysis yielded three themes that described these nurses’ support of breastfeeding on the night shift: competing priorities, incongruent expectations, and influential institutional structures. The need of visitors to see their new family members competed with the needs of mothers to rest and breastfeed their newborns. Helping breastfeeding dyads who experienced difficulties competed with providing care to other patients. Parents’ expectations regarding newborn behavior were incongruent with the reality of newborn feeding and sleeping patterns. Institutional structures that affected the provision of breastfeeding support by nurses included hospital breastfeeding practices, staffing, and policies.ConclusionNurses’ support of breastfeeding on the night shift encompasses a complex interplay of interpersonal interactions with new families and visitors regarding priorities and expectations and negotiating institutional structures such as feeding policies and staffing.     

Prevalence and Factors Affecting Breastfeeding Among Aboriginal Women in Northwestern Ontario

ObjectiveTo evaluate breastfeeding outcomes among Aboriginal women and to determine variables affecting breastfeeding in the early postpartum period.DesignProspective cohort study.SettingTwo sites in Northwestern Ontario, Canada: a tertiary care center and a rural hospital.ParticipantsOne hundred thirty breastfeeding Aboriginal women agreed to participate in the study.MethodsAll women completed a baseline survey in hospital that included questions regarding demographic, prenatal, breastfeeding, obstetric, postpartum, and neonatal characteristics. Women were then telephoned at 4 and 8 weeks postpartum to complete additional questionnaires regarding infant feeding.ResultsLow rates of breastfeeding initiation (69%) and exclusive breastfeeding were identified at 4 (37.5%) and 8 (35.3%) weeks postpartum. Among those who initiated breastfeeding, duration rates at 4 (86%) and 8 weeks (78%) postpartum are comparable to other studies. Variables associated with any and exclusive breastfeeding at 8 weeks included the following: (a) household income, (b) intended breastfeeding duration, (c) plan to exclusively breastfeed, (d) perception of meeting their planned duration goal, and (e) higher breastfeeding self‐efficacy. Partner support was associated with any breastfeeding at 8 weeks but not exclusivity. Women who were breastfeeding exclusively in hospital (prevalence ratio [PR] = .48, 95% confidence interval [CI] [0.27, 0.86]), did not smoke (PR = 2.5, 95% CI [1.4, 4.3]) and/or use substances during pregnancy (PR = 4.5, 95% CI [1.5, 14]) were more likely to be breastfeeding exclusively at 8 weeks.ConclusionMany of the variables may be considered modifiable and amenable to intervention. Targeted interventions should be directed toward improving breastfeeding outcomes among Aboriginal women.     

Breastfeeding support in low and middle-income countries: Secondary analysis of national survey data

BackgroundEarly initiation of breastfeeding and exclusive breastfeeding can reduce infant mortality. Breastfeeding support interventions such as counselling may improve adherence to recommended practices. However, it is not known if these interventions work at the population level.ObjectiveThe aim of this study was to assess the relationship between early postnatal breastfeeding support and recommended breastfeeding practices.Design/settingWe pooled data from 11 Demographic and Health Surveys in Africa (n = 7), South East Asia (n = 2), the Americas (n = 1), and Europe (n = 1) to analyse these associations at the population level.ParticipantsWe limited the data to the most recent live births in the two years before the survey, including 41,431 births.AnalysisWe fitted three multivariable logistic regression models to estimate the relationship between early postnatal breastfeeding support (a newborn postnatal check within an hour of birth plus counselling and observation of breastfeeding within two days) and three breastfeeding outcomes (early initiation of breastfeeding, absence of prelacteal feeding, and exclusive breastfeeding), adjusting for sociodemographic characteristics and birth-related factors.FindingsEarly breastfeeding support was associated with a 24% increase (OR=1.24 95%CI=1.11,1.39) in the odds of initiating breastfeeding within one hour of birth. No relationships were found between breastfeeding support and prelacteal feeding in the first three days or exclusive breastfeeding at six months.Key conclusionWhile postnatal breastfeeding counselling and observation may improve early initiation of breastfeeding, impact is not persistent for longer term breastfeeding outcomes.Implication for practiceImproved training for breastfeeding support and an enabling policy environment are required to improve breastfeeding practices for women and newborns.     

Evaluation of the Supportive Needs of Adolescents during Childbirth Intrapartum Nursing Intervention on Adolescents’ Childbirth Satisfaction and Breastfeeding Rates

ObjectiveTo evaluate the effect of the Supportive Needs of Adolescents during Childbirth (SNAC) intrapartum nursing intervention on adolescents’ childbirth satisfaction and breastfeeding rates.DesignSeparate sample posttest quasi‐experimental.SettingA tertiary hospital intrapartum unit.ParticipantsA convenience sample of 106 parturient adolescents.MethodsDuring Phase 1 the control group received current standard of intrapartum care.During Phase 2, the interventionist nurses provided the SNAC intervention and standard of care to the intervention group.ResultsThe t test indicated higher childbirth satisfaction in the intervention group.Chi‐square analysis indicated that the intervention group was more likely to breastfeed within the first hour after birth. There was no significant relationship between childbirth satisfaction and breastfeeding at three months and no differences between the groups in breastfeeding rates at hospital discharge and three months.ConclusionsThese results suggest that learning the SNAC intervention may help nurses positively influence adolescents’ childbirth experience and timing of breastfeeding initiation. Replication of the study is needed to further explore whether the intervention can significantly influence breastfeeding duration.     

Family members’ infant feeding preferences,maternal breastfeeding exposures and exclusive breastfeeding intentions

BackgroundMaternal breastfeeding intentions are strongly associated with breastfeeding exclusivity and duration. Factors that affect new mothers’ exclusive breastfeeding intentions have not been adequately examined.ObjectiveThe purpose of this study was to examine the association between family member's infant feeding preferences, breastfeeding exposures, and womens’ exclusive breastfeeding intentions.Methods1277 breastfeeding mother-infant pairs were recruited from four public hospitals in Hong Kong. We used multiple logistic and linear regression models to explore the impact of the family members’ infant feeding preferences and breastfeeding exposures on exclusive breastfeeding intentions.Results78.1% mothers reported an intention to exclusively breastfeed, and the median intended duration of exclusive breastfeeding was 26 weeks. The husband's preference for breastfeeding (aOR = 1.67; 95% CI 1.20–2.31), previous breastfeeding experience (aOR = 1.56; 95% CI 1.10–2.23) and attendance at an antenatal breastfeeding class (aOR = 2.09; 95% CI 1.45–3.02) were all strongly associated with higher maternal intention to exclusively breastfeed. For every additional family member who preferred breastfeeding, the odds of intending to exclusively breastfeed increased by 32% (aOR1.32; 95% CI, 1.13–1.55). Similarly, the proportion of participants intending to exclusively breastfeed increased progressively with more breastfeeding exposures.ConclusionsIncluding fathers and other significant family members in antenatal breastfeeding education can help to maximize breastfeeding support for the new mother and encourage new mothers to exclusively breastfeed.     

An Interprofessional Quality Improvement Project to Implement Maternal/Infant Skin‐to‐Skin Contact During Cesarean Delivery

Immediate skin‐to‐skin contact between a mother and her newborn has been associated with successful breastfeeding outcomes. One of the challenges nurses face in promoting skin‐to‐skin occurs in the operating room during a cesarean delivery. Utilizing an interprofessional approach for this quality improvement project, we successfully implemented skin‐to‐skin contact for all eligible mother/infant couplets after cesarean birth. Exclusive breastfeeding rates for these women increased as a result.     

Initiation de l’allaitement maternel et sevrage précoce : étude prospective du réseau périnatalité Loire–Nord Ardèche

ObjectivesThe World Health Organization recommends exclusive breastfeeding of infants up to 6 months. The proportion of breastfeeding initiation and duration increased more slowly in France than in neighboring European countries. The perinatal network data are incomplete. The objective of this study is to evaluate within the perinatal network “Loire–Nord Ardèche” (ELENA), breastfeeding rates in hospital discharge and at 2 months, and identify needs for maternal support.Patients and methodsProspective and declarative study by written questionnaire, with all the women volunteers who gave birth in October 2011 in a maternity of our perinatal network.ResultsPopulation concerns 426 women volunteers of 968 new mothers. Two hundred and ninety-four questionnaires were used: 69% of women initiated breastfeeding, 63% have continued after the stay in the maternity and 50% at 2 months. Eighty percent chose to breastfeed before pregnancy, mainly for child health, 65% with the support of their spouse, 58% if their mother had breastfed. Simple pathologies of breastfeeding and childbirth were responsible for weaning. A third of women in difficulty have not consulted anyone, one third wanted more practical help and systematic support motherhood.Discussion and conclusionThe rate of initiation of breastfeeding or duration and the great influence of the surroundings of the mother, similar in this study to literature data, call for enhanced prenatal information for parents and systematic “lactation” consultation in the early post-partum, by trained professionals and with the help of support associations for breastfeeding. This study showed a clear need to support breastfeeding. It has also allowed targeting actions that would be able to avoid the majority of early weaning.     

Effect of Pre- and Postdischarge Interventions on Breastfeeding Outcomes and Weight Gain Among Premature Infants

ObjectiveTo investigate the effect of pre- and postdischarge interventions on breastfeeding outcomes and weight gain among preterm infants.Data SourcesPubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) database were searched for study selection using MeSH terms infant/premature, breastfeeding, weight gain, patient discharge, postnatal care, and counseling.Study SelectionInclusion criteria included studies that involved preterm infants who were born less than or equal to 37 weeks of gestation, randomized controlled trials that were in English, conducted in developed countries, and had breastfeeding and weight gain outcomes. A total of 8 articles met inclusion criteria.Data ExtractionAll data related to breastfeeding outcomes including duration, exclusivity, maternal satisfaction, and weight gain were extracted from the randomized controlled trials for the purpose of data synthesis.Data SynthesisA total of 310 studies were reviewed. Eight randomized controlled trials met the inclusion criteria. Gestational age of the infants in the studies ranged from 26 to 37 weeks. The results revealed that kangaroo care, peer counseling, in-home breast milk intake measurement, and postdischarge lactation support improved breastfeeding outcomes among preterm infants, and that maternal satisfaction improved with postdischarge interventions. No significant evidence of pre- and postdischarge interventions on weight gain was found.ConclusionsPre- and postdischarge interventions were effective in promoting breastfeeding exclusivity, duration, and maternal satisfaction among mothers of preterm infants. These findings have important clinical implications that support the need for evidence-based breastfeeding interventions for preterm infants before discharge and vigilant postdischarge support. Research to determine more effective interventions to promote exclusive and long-term breastfeeding among preterm infants is required.     

Association between Intrapartum Interventions and Breastfeeding Duration

Introduction : Few women who reside in Hong Kong exclusively breastfeed, and one‐half stop breastfeeding within the first few months. There is little research in this population on the association between intrapartum interventions and breastfeeding duration. Methods : A sample of 1280 mother‐infant pairs were recruited from the obstetric units of 4 public hospitals in Hong Kong and followed prospectively for 12 months or until the infant was weaned. The outcome variables for this analysis were the duration of any and exclusive breastfeeding. Predictor variables were 4 intrapartum interventions: receipt of opioid pain medication, induction versus spontaneous labor, epidural administration, and mode of birth. We used Cox proportional hazards modeling to assess the impact of intrapartum interventions on the duration of any and exclusive breastfeeding, and we constructed Kaplan‐Meier survival curves to evaluate the cumulative impact of multiple intrapartum interventions on breastfeeding outcomes. Results : Bivariate analysis showed that induction of labor (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.09‐1.41), opioid pain medication (HR, 1.21; 95% CI, 1.06‐1.37), and having an emergency cesarean birth (HR, 1.22; 95% CI, 1.01‐1.48) were associated with a shorter duration of any breastfeeding. Induction of labor (HR, 1.23; 95% CI, 1.08‐1.39) and having an emergency cesarean birth (HR, 1.25; 95% CI, 1.05‐1.51) were associated with a shorter duration of exclusive breastfeeding. After controlling for known confounding variables, there was no longer any association between individual intrapartum interventions and the duration of any or exclusive breastfeeding. The median duration of breastfeeding for participants who experienced a natural birth with no intrapartum interventions was 9 weeks compared with 5 weeks for participants who experienced at least 3 intrapartum interventions. Discussion : Clinicians working with new breastfeeding mothers should focus on providing additional support to mothers who experience a difficult labor and birth with multiple interventions to improve their breastfeeding experiences.