Emzirmeyi Bırakma Nedenleri: Bir Sistematik Derleme

Öz

Amaç: Dünya Sağlık Örgütü (DSÖ) önerilerine göre, bebeklerin optimal büyümeleri için ilk altı ay yalnızca anne sütü ile beslenmeleri ve emzirmenin en az iki yıl sürdürülmesi gerekmektedir. Bu sistematik derleme, emzirmeyi bırakma nedenlerini bireysel, bebeğe ait, psikososyal ve çevresel faktörler çerçevesinde inceleyen çalışmaları derlemeyi ve değerlendirmeyi amaçlamaktadır. Yöntem: 2018-2023 yılları arasında yayımlanmış, emzirmeyi bırakma nedenlerini araştıran, Türkçe ve İngilizce dilindeki nitel ve nicel araştırmalar dahil edilmiştir. Derlemeye alınan 22 çalışmada toplam 9.758 anne ve 6.170 bebek yer almıştır. Bulgular: Emzirmeyi bırakma nedenleri dört faktör altında incelenmiştir: bireysel (süt yetersizliği, meme sorunları, mama kullanımı), bebeğe ait (yetersiz kilo alımı, memeyi reddetme), psikososyal (stres, önceki olumsuz deneyimler, düşük özgüven) ve çevresel (işyerinde uygun emzirme koşullarının eksikliği, sosyal destek yetersizliği, mitler). Sonuç: En yaygın nedenler bireysel ve çevresel faktörlerdir. Bu faktörlerin önlenmesi veya azaltılması, kadın sağlığını iyileştirmek için önemlidir. Sağlık profesyonellerinin emzirmeyi teşvik eden politikalar geliştirmesi kritik rol oynamaktadır.

Anahtar Kelimeler

• emzirme
• sütten kesme
• risk faktörleri

Reasons for Breastfeeding Cessation: A Systematic Review

Öz

Objective: According to the World Health Organization (WHO) recommendations, infants should be exclusively breastfed for the first six months to ensure optimal growth, and breastfeeding should continue for at least two years. This systematic review aims to compile and evaluate studies investigating breastfeeding cessation within four domains: individual, infant-related, psychosocial, and environmental factors. Methods: Qualitative and quantitative studies published between 2018 and 2023 in Turkish and English, which examined the reasons for breastfeeding cessation were included. A total of 22 studies with 9,758 mothers and 6,170 infants were reviewed. Results: The reasons for breastfeeding cessation were categorized into four factors: individual (insufficient milk supply, nipple problems, formula use), infant-related (insufficient weight gain, breast refusal), psychosocial (stress, previous negative experiences, low self-confidence), and environmental (lack of appropriate breastfeeding conditions at the workplace, inadequate social support, myths). Conclusion: The most common reasons for breastfeeding cessation are individual and environmental factors. Preventing or reducing these factors is important for improving maternal health. Healthcare professionals play a critical role in developing policies that promote breastfeeding.

Anahtar Kelimeler

• breast feeding
• weaning
• risk factors

Kaynakça

1. Meek JY, Noble L. American Academy of Pediatrics Policy Statement: Breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988.
2. World Health Organization (WHO). Infant and young child feeding Available at: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding Accessed August 13,2025
3. The American College of Obstetricians and Gynecologists (ACOG). Breastfeeding your baby Available at: https://www.acog.org/womens-health/faqs/breastfeeding-your-baby Accessed August 13,2025
4. Matriano MG, Ivers R, Meedya S. Factors that influence women’s decision on infant feeding: An integrative review. Women and Birth. 2022 Sep;35(5):430-9.
5. Victora CG, Bahl R, Barros AJD, França GVA, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet 2016;387(10017):475-90
6. UNICEF. The State of the World’s Children 2019: Children, food and nutrition-Growing well in a changing world. New York: UNICEF;2019.p.71 Available at: https://www.unicef.org/reports/state-of-worlds-children-2019 Accessed August 13,2025
7. TNSA. Hacettepe Üniversitesi Türkiye Nüfus ve Sağlık Araştırması, 2018 [Internet]. Hacettepe University of Population Studies. 2018. p. 153-154 Available at: https://fs.hacettepe.edu.tr/hips/dosyalar/yayinlar/2019_tnsa_anarapor_compressed.pdf Accessed August 13,2025
8. Miller JD, Collins SM, Boateng GO, Widen EM, Natamba B, Achoko W, and et al. Pathways linking social support, self-efficacy, and exclusive breastfeeding among women in northern Uganda. Glob Public Health. 2022;17(12):3506-18.

9. Cortés-Rúa L, Díaz-Grávalos GJ. Early interruption of breastfeeding. A qualitative study. Enferm Clin. 2019 Jul-Aug;29(4):207-15.
10. Tracz J, Gajewska D. Factors Influencing the duration of breastfeeding among Polish women. J Mother Child. 2020 Jul 29;24(1):39-46.
11. Barnes C, Hauck Y, Mabbott K, Officer K, Ashton L, Bradfield Z. Influencers of women’s choice and experience of exclusive formula feeding in hospital. Midwifery. 2021 Dec;103:103093.
12. Irmak N, Uzuner A, Çifçili SS, Aksoy S, Başaran B, Tellioǧlu M. The effect of an Empowerment-Based Human Centered Educational Program on early weaning. Prim Health Care Res Dev. 2021 Aug 25:22:e40
13. Yahşi A, Şaylı T. Factors affecting breast milk and the effects of pacifier use on breastfeeding. Pamukkale Medical Journal. 2022;15(4):788-95.
14. Yüzer-Alsaç S, Polat S. Annelerin emzirmeyi sonlandırma sürecine ilişkin bilgi ve uygulamaları. Florence Nightingale J Nurs. 2018;26(1):11-20. doi:10.26650/fnjn.387152.
15. Morrison AH, Gentry R, Anderson J. Mothers’ reasons for early breastfeeding cessation. MCN Am J Matern Child Nurs 2019 Nov/Dec;44(6):325-30. Available at: https://journals.lww.com/mcnjournal/fulltext/2019/11000/mothers__reasons_for_early_breastfeeding_cessation.4.aspx Accessed August 13,2025
16. Mangrio E, Persson K, Bramhagen AC. Sociodemographic, physical, mental and social factors in the cessation of breastfeeding before 6 months: A systematic review. Scand J Caring Sci 2018 Jun;32(2):451-65. https://doi.org/10.1111/scs.12489 Available at: https://onlinelibrary.wiley.com/doi/10.1111/scs.12489 Accessed August 13,2025
17. Methley AM, Campbell S, Chew-Graham C, Mcnally R, Cheraghi-Sohi S. PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res 2014 Nov 21:14:579 doi: 10.1186/s12913-014-0579-0
18. Cooke A, Smith D, Booth A. Beyond PICO: The SPIDER tool for qualitative evidence synthesis. Qual Health Res 2012 Oct;22(10):1435-43. Available at: https://pubmed.ncbi.nlm.nih.gov/22829486/ Accessed August 13,2025
19. Chhetri S, Rao AP, Guddattu V. Factors affecting exclusive breastfeeding (EBF) among working mothers in Udupi Taluk, Karnataka. Clin Epidemiol Glob Health. 2018;6(4):216-9. doi: https://doi.org/10.1016/j.cegh.2018.06.008
20. Yourkavitch J, Rasmussen KM, Pence BW, Aiello A, Ennett S, Bengtson AM, vd. Early, regular breast-milk pumping may lead to early breast-milk feeding cessation. Public Health Nutr. 2018 June;21(9):1726-36. doi: 10.1017/S1368980017004281.
21. Beyene AM, Liben ML, Arora A. Factors associated with the early termination of exclusive breastfeeding among mother-infant dyads in Samara-Logia, Northeastern Ethiopia. BMC Pediatr. 2019;19:428 doi: 10.1186/s12887-019-1803-1.
22. McCoy MB, Heggie P. In-hospital formula feeding and breastfeeding duration. Pediatrics. 2020 Jul;146(1):e20192946 doi: 10.1542/peds.2019-2946.
23. Ericson J, Palmér L. Cessation of breastfeeding in mothers of preterm infants—A mixed method study. PLoS One. 2020 May 15;15(5):e0233181 doi: 10.1371/journal.pone.0233181.
24. Al-Shahwan M, Gacem S, Hassan N, Djessas F, Jairoun A, Al-Hemyari S. A study to identify the most common reasons to wean among breastfeeding mothers in UAE. J Pharm Bioallied Sci. 2020;12(1):72-6. doi: 10.4103/jpbs.JPBS_230_19.
25. Kebede T, Woldemichael K, Jarso H, Bekele BB. Exclusive breastfeeding cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. Int Breastfeed J. 2020;15:6. doi: 10.1186/s13006-019-0250-9.
26. Adalili A, Mahalli A. Factors associated with cessation of exclusive breastfeeding. J Multidiscip Healthc. 2021;24:239-46. doi: 10.2147/JMDH.S277819.
27. Ávila-Ortiz MN, Castro-Sánchez AE, Martínez-González EA, Núñez-Rocha GM, Zambrano-Moreno A. Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals. Int Breastfeed J. 2020;15:73. doi:10.1186/s13006-020-00316-6.
28. Raihan MJ, Choudhury N, Haque MA, Farzana FD, Ali M, Ahmed T. Feeding during the first 3 days after birth other than breast milk is associated with early cessation of exclusive breastfeeding. Matern Child Nutr. 2020 Jul;16(3):e12971 doi: 10.1111/mcn.12971.
29. Rahat H, Qazi WA, Bokhari NA, Jahan S, Begum R, ur Rasheed H. Association of breastfeeding cessation with health-related quality of life in working multiparous women of Rawalpindi and Islamabad. J Pak Med Assoc. 2020 Oct 01;70(10):1841-4. doi: 10.5455/JPMA.31045.
30. Al-Katufi B, Al-Shikh M, Al-Hamad R, Al-Hajri A, Al-Hejji A. Barriers in continuing exclusive breastfeeding among working mothers in primary health care in the Ministry of Health in Al-Ahsa region, Saudi Arabia. J Family Med Prim Care. 2020;9(2):957. doi:10.4103/jfmpc.jfmpc_844_19.
31. Hashim S, Ishak A, Muhammad J. Unsuccessful exclusive breastfeeding and associated factors among the healthcare providers in East Coast, Malaysia. Korean J Fam Med. 2020;41(6):416-21. doi: 10.4082/kjfm.19.0060.
32. de Holanda ER, da Silva IL. Factors associated with early weaning and spatial pattern of breastfeeding in territory in the Zona da Mata of Pernambuco, Brazil. Rev Bras Saude Materno Infantil. 2022;22(4):803-12. doi: http://dx.doi.org/10.1590/1806-930202200040005
33. DiTomasso D, Wambach KA, Roberts MB, Erickson-Owens DA, Quigley A, Newbury JM. Maternal worry about infant weight and its influence on artificial milk supplementation and breastfeeding cessation. J Hum Lact. 2022 Feb 01;38(1):177-89. doi: 10.1177/08903344211000284.
34. Vázquez-Osorio IM, Vega-Sánchez R, Maas-Mendoza E, Heller Rouassant S, Flores-Quijano ME. Exclusive breastfeeding and factors influencing its abandonment during the 1st month postpartum among women from semi-rural communities in Southeast Mexico. Front Pediatr. 2022 Feb 18;10:826295. doi: 10.3389/fped.2022.826295.
35. de Assunção Conceição FOV, Zanin L, de Araújo Neto AP, Pinheiro FS, Flório FM. Factors associated with early weaning in the human milk bank of a university hospital. Rev Bras Saude Materno Infantil. 2023;23:1-13. doi:https://doi.org/10.1590/1806-9304202300000450
36. Temesgen K, Andarge E, Fikadu T, Bekele M, Chisha Y, Esubalew H, and et al. Early cessation of breastfeeding and the associated factors among mothers with children aged 2 to 3 years in rural Southern Ethiopia: A community-based cross-sectional study. BMC Nutr. 2023;9(1):22. doi: 10.1186/s40795-023-00681-5.
37. Joanna Briggs Institute. Critical Appraisal Tools. Internet. JBI; erişim 25 Haziran 2024]. Available at: https://jbi.global/critical-appraisal-tools
38. Kurniawan D, Chertok I, Haile Z. The relationship between place of birth and early breastfeeding initiation in Indonesia. J Hum Lact. 2021 May;37(2):357-69. doi: 10.1177/0890334420945299.
39. Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: A literature review. Midwifery. 2021 Dec;103:103117. doi: 10.1016/j.midw.2021.103117. 
40. Mikami F, Francisco R, Hernandez A, Zugaib M, Brizot M. Breastfeeding twins: Factors related to weaning. Journal of Human Lactation. 2018;34(4):749-59. doi: 10.1177/0890334418767382. 
41. Wilson JC. Using social media for breastfeeding support. Nurs Womens Health. 2020;24(5):332-43.
42. Jiravisitkul P, Thonginnetra S, Kasemlawan N, Suntharayuth T. Supporting factors and structural barriers in the continuity of breastfeeding in the hospital workplace. Int Breastfeed J. 2022;17(1):87. doi:10.1186/s13006-022-00533-1
43. Ribeiro KV, Florentino CLV, Mariano DCA, Peres PLP, Rodrigues BMRD. Breastfeeding and informal work: The experience of working mothers. Rev Pró-UniverSUS, 2017;8(2):3-9.
44. Steurer LM. Maternity leave length and workplace policies’ impact on the sustainment of breastfeeding: Global perspectives. Public Health Nurs. 2017;34(3):286-94. doi: 10.1111/phn.12321.
45. Susiloretni KA, Hadi H, Blakstad MM, Smith ER, & Shankar AH. Does exclusive breastfeeding relate to the longer duration of breastfeeding? A prospective cohort study. Midwifery, 2019;69:163-71. doi: 10.1016/j.midw.2018.11.008