To assess which determinants influence the mother’s choice to breastfeed or formula-feed her infant, as well as the roles that social and professional support play in this process.

Descriptive study.

Pregnant women who visited midwives, general practitioners or gynaecologists during their pregnancy in the South-West Overijssel region of the Netherlands from 1 February-1 September 2000 were asked to participate in the study. They completed questionnaires during the 27th and 36th week of pregnancy, 1 day post-partum, and 1 month and 4 months after delivery. Collected data included sociodemographic characteristics, the perceived professional and social support when choosing between breastfeeding or formula feeding, and reasons for premature cessation of breastfeeding.

404 women participated in the study. 95% had already made a feeding choice during pregnancy: approximately 80% chose to breastfeed. These women had a higher level of education, were less likely to smoke, were more likely to have breastfed previously and had been breastfed themselves more often than the women who chose formula feeding (p < 0.05). In the 27th week of pregnancy, 56% of the women indicated that they had not received professional support when making their choice. Women who had received professional support were more likely to opt for breastfeeding. This relationship was also found to hold true 1 day after delivery. At that time 76% of mothers breastfed; after 4 months this figure had dropped to 27%. The main reasons mothers gave for switching to formula feeding were concerns that their infant was not growing adequately, breastfeeding problems and returning to work. They indicated that the provision of information and support, both before and after the birth, had been inadequate. Support from their social environment was not found to be significantly associated with the feeding choice.

The choice to breastfeed or formula-feed was made before birth. Professional support plays an important role in this choice, not only before birth but also immediately afterwards. Provision of information and support by professionals before and after delivery could increase the number of women choosing to breastfeed and the length of time these women breastfeed.