More mothers are breast-feeding longer

The number of women who start breast-feeding in the hospital and who are still nursing six months later is at an all-time high, according to a survey released Tuesday. Yet 30 percent of new mothers never try breast-feeding, and 67 percent have quit by six months, the Ross Mothers Survey found.

Conducted yearly since 1955 by the formula maker Ross Products, a division of Abbott Laboratories, the survey is considered the definitive picture of breast-feeding in the United States, in part because the government does not collect such data.

Though there have been large increases among most women, black mothers still lag behind their white and Hispanic counterparts. And among women who traditionally have had higher breast-feeding rates — the college-educated, over-30 mothers who live in the Mountain and Pacific regions of the United States — there was a slight decline in in-hospital initiation from 2001 to 2002.

The rates may reflect the continuing reality that breast-feeding can be difficult, frustrating and, at times, mysterious, especially since most women begin with little, if any, solid knowledge or skills.

This year, a federal panel found that a class — as simple as one hour of instruction — can give a woman the help she needs and the wherewithal to stick with breast-feeding for at least the first few months. That panel, the Federal Preventive Services Task Force, recommended that health professionals encourage women to attend a breast-feeding class.

"Just telling a woman to breast-feed is not enough," said the task force chairman, Dr. Alfred Berg, who is chairman of the department of family medicine at the University of Washington.

After reviewing 22 studies of efforts aimed at helping women breast-feed, the panel found that a structured class was more effective than any other program, including peer counseling. It did not seem to matter whether the class was offered before or after birth, or if it was large or small.

"The ones that were successful seemed to have an explicit structure," covering anatomy and physiology, myths and misconceptions, basic techniques, and how to overcome obstacles, said Dr. Jeanne-Marie Guise, a task force member and an obstetrics and gynecology professor at Oregon Health & Science University.

The panel estimated that for every three to five women who attend a class, at least one would still be breast-feeding three months later. Additional support through postdelivery phone calls, at-home or in-hospital visits with lactation consultants, or peer counseling, extended breast-feeding beyond three months.