Results of a survey of mothers helped to clarify the reasons for the "failure" of breastfeeding in the Russian Federation

Cover Page

Cite item


Background. Breast milk is the most important food for the infant. A strong body of evidence now exists to show the health benefits of breastfeeding (BF) for infants. There is a growing conviction among some of today's young mothers to remain naturally breastfed and to fight for every drop of milk. However, despite UNICEF's investment in programmes to support the sustainability of breastfeeding, there is no consistent trend towards increased longevity.

Aim. We seek to understand in detail the reasons behind the obstacles to successful, long-term breastfeeding in every single region of Russia.

Materials and methods. We surveyed 801 women who had completed breastfeeding and selected the most comprehensive 459 questionnaires.

Results. Analysis of the obtained data allowed us to identify a number of predictors of premature lactation completion, to identify conditions under which women are able to breastfeed their infants for a long time, and to reveal a number of "pain points" of BF in our country.

Conclusion. We call upon paediatricians to improve their knowledge and to become specialists in the area of breastfeeding by focusing their preventive work on safeguarding and supporting breastfeeding.

Full Text

Restricted Access

About the authors

Anastasiia E. Kuchina

Russian Medical Academy of Continuous Professional Education


Graduate Student

Russian Federation, Moscow

Irina N. Zakharova

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
ORCID iD: 0000-0003-4200-4598

D. Sci. (Med.), Prof.

Russian Federation, Moscow


  1. Infant and young child nutrition. Available at: Accessed: 19.09.2021.
  2. Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. 2012;2012(8):CD003517. doi: 10.1002/14651858.CD003517.pub2
  3. Eidelman AI, Schanler RJ, Johnston M, et al. Breastfeeding and the use of human milk. Pediatrics. 2012;129:e827-e841.
  4. Программа оптимизации вскармливания детей первого года жизни в Российской Федерации: методические рекомендации. ФГАУ «НМИЦ здоровья детей» Минздрава России. М., 2019 [Programma optimizatsii vskarmlivaniia detei pervogo goda zhizni v Rossiiskoi Federatsii: metodicheskie rekomendatsii. FGAU "NMITs zdorov'ia detei" Minzdrava Rossii. Moscow, 2019 (in Russian)].
  5. Victora CG, Bahl R, Barros AJ, et al.; Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. doi: 10.1016/S0140-6736(15)01024-7
  6. Takahashi K, Ganchimeg T, Ota E, et al. Prevalence of early initiation of breastfeeding and determinants of delayed initiation of breastfeeding: secondary analysis of the WHO Global Survey. Sci Rep. 2017;7:44868. doi: 10.1038/srep44868
  7. Глобальная стратегия охраны здоровья женщин, детей и подростков (2016–2030 гг.). Инициатива каждая женщина каждый ребенок, 2015 г. Режим доступа: Ссылка активна на 19.09.2021 [Global'naia strategiia okhrany zdorov'ia zhenshchin, detei i podrostkov (2016–2030 gg.). Initsiativa kazhdaia zhenshchina kazhdyi rebenok, 2015 g. Available at: Accessed: 19.09.2021 (in Russian)].
  8. Brown KH, Black RE, Lopez de Romana G, Creed de Kanashiro H. Infant-feeding practices and their relationship with diarrheal and other diseases in Huascar (Lima), Peru. Pediatrics. 1989;83:31-40.
  9. Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics. 2010;126:e18-25.
  10. Meinzen-Derr J, Poindexter B, Wrage L, et al. Role of human milk in extremely low birth weight infants’ risk of necrotizing enterocolitis or death. J Perinatol. 2009;29:57-62.
  11. Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeeding Med. 2014;9:184-90.
  12. Duijts L, Jaddoe VW, Hofman A, Moll HA. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics. 2010;126:e18-25.
  13. Lopez-Alarcon M, Villalpando S, Fajardo A. Breast-feeding lowers the frequency and duration of acute respiratory infection and diarrhea in infants under six months of age. J Nutr. 1997;127:436-43.
  14. Ladomenou F, Moschandreas J, Kafatos A, et al. Protective effect of exclusive breastfeeding against infections during infancy: a prospec- tive study. Arch Dis Child. 2010;95:1004-8.
  15. Kim JH, Lee SW, Lee JE, et al. Breastmilk Feeding during the First 4 to 6 Months of Age and Childhood Disease Burden until 10 Years of Age. Nutrients. 2021;13(8):2825. doi: 10.3390/nu13082825
  16. von Kries R, Koletzko B, Sauerwald T, et al. Breast feeding and obesity: cross sectional study. BMJ. 1999;319:147-50.
  17. Gillman MW, Rifas-Shiman SL, Camargo CA Jr, et al. Risk ofoverweight amongadolescents whowere breastfed as infants. JAMA. 2001;285:2461-7.
  18. Munblit D, Verhasselt V. Allergy prevention by breastfeeding: possible mechanisms and evidence from human cohorts. Curr Opin Allergy Clin Immunol. 2016;16:427-33.
  19. Royal C, Gray C. Allergy Prevention: An Overview of Current Evidence. Yale J Biol Med. 2020;93(5):689-98.
  20. Kramer MS, Chalmers B, Hodnett ED, et al. Promotion of Breastfeeding Intervention Trial (PROBIT): a randomized trial in the Republic of Belarus. JAMA. 2001;285:413-20.
  21. Su Q, Sun X, Zhu L, et al. Breastfeeding and the risk of childhood cancer: a systematic review and dose-response meta-analysis. BMC Med. 2021;19(1):90. doi: 10.1186/s12916-021-01950-5
  22. Kucukcongar A, Oguz A, Pinarli FG, et al. Breastfeeding and childhood cancer: is breastfeeding preventative to childhood cancer? Pediatr Hematol Oncol. 2015;32:374-81.
  23. Plunkett BA, Mele L, Casey BM, et al.; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Association of Breastfeeding and Child IQ Score at Age 5 Years. Obstet Gynecol. 2021;137(4):561-70 (in Russian)]. doi: 10.1097/AOG.0000000000004314
  24. Радзинский В.Е. Медицина молочной железы и гинекологические болезни. 2-е изд., перераб. и доп. М.: Медиабюро StatusPraesens, 2017 [Radzinsky VE. Meditsina molochnoi zhelezy i ginekologicheskie bolezni. 2nd ed., updated and enlarged. Moscow: Mediabureau StatusPraesens, 2017 (in Russian)].
  25. Амирова В.Р., Валиулина А.Я., Гиздатуллина К.Х. и др. Влияние продолжительности грудного вскармливания на качество жизни детей младенческого возраста. Медицинский вестник Башкортостана. 2019;14(1):18-22 [Amirova VR, Valiulina AIa, Gizdatullina KKh, et al. Vliianie prodolzhitel'nosti grudnogo vskarmlivaniia na kachestvo zhizni detei mladencheskogo vozrasta. Meditsinskii vestnik Bashkortostana. 2019;14(1):18-22 (in Russian)].
  26. Ньюман Дж., Питман Т. Грудное вскармливание. Пер. с англ. Под ред. И.И. Рюминой. М.: ГЭОТАР-Медиа, 2018 [N'iuman Dzh, Pitman T. Grudnoe vskarmlivanie. Per. s angl. Pod red. II Riuminoi. Moscow: GEOTAR-Media, 2018 (in Russian)].
  27. Liu R, Edwards CG, Cannavale CN, et al. Weight Status and Visceral Adiposity Mediate the Relation between Exclusive Breastfeeding Duration and Skin Carotenoids in Later Childhood. Curr Dev Nutr. 2021;5(3):nzab010. doi: 10.1093/cdn/nzab010
  28. Zimmermann P, Curtis N. Breast milk microbiota: A complex microbiome with multiple impacts and conditioning factors. Journal of Infection. 2020(81):17-47.
  29. Fernández L, Langa S, Martín V, et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacol Res. 2013;69(1):1-10. doi: 10.1016/j.phrs.2012.09.001
  30. Indrio F, Martini S, Francavilla R, et al. Epigenetic Matters: The Link between Early Nutrition, Microbiome, and Long-term Health Development. Front Pediatr. 2017;22(5):178.
  31. Global breastfeeding scorecard, 2018. Available at: Accessed: 19.09.2021.
  32. Global breastfeeding scorecard, 2021. Available at: Accessed: 19.09.2021.
  33. Global breastfeeding scorecard. Available at: Accessed: 19.09.2021.
  34. Здравоохранение по данным Росстат. Режим доступа: Ссылка активна на 19.09.2021 [Zdravookhranenie po dannym Rosstat. Available at: Accessed: 19.09.2021 (in Russian)].
  35. Россия – среди лидеров по грудному вскармливанию: успешное сотрудничество ВОЗ и Минздрава РФ. Режим доступа: Ссылка активна на 19.09.2021 [Rossiia – sredi liderov po grudnomu vskarmlivaniiu: uspeshnoe sotrudnichestvo VOZ i Minzdrava RF. Available at: Accessed: 19.09.2021 (in Russian)].
  36. Fair FJ, Morrison A, Soltani H. The impact of Baby Friendly Initiative accreditation: An overview of systematic reviews. Matern Child Nutr. 2021;17(4):e13216. doi: 10.1111/mcn.13216
  37. Countries failing to stop harmful marketing of breast-milk substitutes, warn WHO and UNICEF. Available at: Accessed: 19.09.2021.
  38. Perrin MT, Fogleman AD, Newburg DS, Allen JC. A longitudinal study of human milk composition in the second year postpartum: implications for human milk banking. Matern Child Nutr. 2017;13. doi: 10.1111/mcn.12239
  39. Ventura A, Hupp M, Lavond J. Mother-infant interactions and infant intake during breastfeeding versus bottle-feeding expressed breast milk. Matern Child Nutr. 2021;17(4):e13185. doi: 10.1111/mcn.13185
  40. Wojcicki JM. Maternal prepregnancy body mass index and initiation and duration of breastfeeding: a review of the literature. J Womens Health (Larchmt). 2011;20(3):341-7. doi: 10.1089/jwh.2010.2248
  41. Дедов И.И., Мокрышева Н.Г., Мельниченко Г.А., и др. Ожирение. Клинические рекомендации. Consilium Medicum. 2021;23(4):311-25 [Dedov II, Mokrysheva NG, Mel’nichenko GA, et al. Obesity. Clinical guidelines. Consilium Medicum. 2021;23(4):311-25 (in Russian)]. doi: 10.26442/20751753.2021.4.200832
  42. Reichental ZL, O'Brien VM, O'Reilly SL. Interventions to support women with overweight or obesity or gestational diabetes mellitus to initiate and continue breastfeeding: Systematic review and meta-analysis. Obes Rev. 2021;e13371. doi: 10.1111/obr.13371
  43. Amaral YNV, Rocha DM, Silva LML, et al. Morbidades maternas modificam a composição nutricional do leite humano? uma revisão sistemática. Cien Saude Colet. 2019;24(7):2491-8.
  44. Jatta F, Sundby J, Vangen S, et al. Association between Maternal Origin, Pre-Pregnancy Body Mass Index and Caesarean Section: A Nation-Wide Registry Study. Int J Environ Res Public Health. 2021;18(11):5938. doi: 10.3390/ijerph18115938
  45. Vince K, Brkić M, Poljičanin T, Matijević R. Prevalence and impact of pre-pregnancy body mass index on pregnancy outcome: a cross-sectional study in Croatia. J Obstet Gynaecol. 2021;41(1):55-9. doi: 10.1080/01443615.2019.1706157
  46. Salvetti MG, Lauretti LG, Muniz RC, et al. Characteristics of pregnant women at risk and relationship with type of delivery and complications. Rev Bras Enferm. 2021;74(4):e20200319. doi: 10.1590/0034-7167-2020-0319
  47. Радзинский В.Е. Акушерская агрессия. М.: StatusPraesens, 2017 [Radzinsky VE. Akusherskaia agressiia. Moscow: StatusPraesens Publishing House, 2017 (in Russian)].
  48. Harrison MS, Garces AL, Goudar SS, et al. Cesarean birth in the Global Network for Women's and Children's Health Research: trends in utilization, risk factors, and subgroups with high cesarean birth rates. Reprod Health. 2020;17(Suppl. 3):165. doi: 10.1186/s12978-020-01021-7
  49. Betran AP, Torloni MR, Zhang JJ, Gülmezoglu AM; WHO Working Group on Caesarean Section. WHO Statement on Caesarean Section Rates. BJOG. 2016;123(5):667-70. doi: 10.1111/1471-0528.13526
  50. Агеева Л.И., Александрова Г.А., Зайченко Н.М., и др. Здравоохранение в России. 2019: Стат.сб./Росстат. М., 2019 [Ageeva LI, Aleksandrova GA, Zaichenko NM, et al. Zdravookhranenie v Rossii. 2019: Moscow, 2019 (in Russian)].
  51. Sodeno M, Tappis H, Burnham G, Ververs M. Associations between caesarean births and breastfeeding in the Middle East: a scoping review. East Mediterr Health J. 2021;27(9):931-40. doi: 10.26719/emhj.21.027
  52. Li L, Wan W, Zhu C. Breastfeeding after a cesarean section: A literature review. Midwifery. 202114;103:103117. doi: 10.1016/j.midw.2021.103117
  53. Prior E, Santhakumaran S, Gale C, et al. Breastfeeding after cesarean delivery: a systematic review and meta-analysis of world literature. Am J Clin Nutr. 2012;95(5):1113-35. doi: 10.3945/ajcn.111.030254
  54. Sevelsted A, Stokholm J, Bonnelykke K, Bisgaard H. Cesarean section and chronic immune disorders. Obstet Gynecol Surv. 2015;135(1):92-8.
  55. Kim K, Henriksen L. Cesarean section and disease associated with immune function. J Allergy Clin Immunol. 2015;137(2):587-90.
  56. Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS Med. 2018;15(1):e1002494.
  57. Zhao J, Zhao Y, Du M, et al. Does Caesarean Section Affect Breastfeeding Practices in China? A Systematic Review and Meta-Analysis. Matern Child Health J. 2017;21(11):2008-24. doi: 10.1007/s10995-017-2369-x
  58. Patil DS, Pundir P, Dhyani VS, et al. A mixed-methods systematic review on barriers to exclusive breastfeeding. Nutr Health. 2020;26(4):323-46. doi: 10.1177/0260106020942967
  59. Raihana S, Alam A, Huda TM, Dibley MJ. Factors associated with delayed initiation of breastfeeding in health facilities: secondary analysis of Bangladesh demographic and health survey 2014. Int Breastfeed J. 2021;16(1):14. doi: 10.1186/s13006-021-00360-w
  60. Alamolhoda SH, Amiraliakbari S, Baghban A, Esmaili S. Effects of Aloe vera gel on breast fissures in breastfeeding women. Pajoohandeh Journal. 2014;19(1):13-7.
  61. Травина М.Л., Попов А.Г., Попов С.А., Куликова Е.В. Профилактика трещин соска молочной железы в ранний послеродовый период. Вопросы современной педиатрии. 2017;16(4):297-303 [Travina ML, Popov AG, Popov SA, Kulikova EV. Prevention of nipple cracks of the mammary gland in the early postnatal period. Current Pediatrics. 2017;16(4):297-303 (in Russian)]. doi: 10.15690/vsp.v16i4.1776
  62. Буданов П.В. Физиология и патология лактации. Евразийский союз ученых. 2019;66(9-3):20-3 [Budanov PV. Fiziologiia i patologiia laktatsii. Evraziiskii soiuz uchenykh. 2019;66(9-3):20-3 (in Russian)]. doi: 10.31618/ESU.2413-9335.2019.3.66.311
  63. Geddes DT, Gridneva Z, Perrella SL, et al. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients. 2021;13(9):3071. doi: 10.3390/nu13093071
  64. Patil DS, Pundir P, Dhyani VS, et al. A mixed-methods systematic review on barriers to exclusive breastfeeding. Nutr Health. 2020;26(4):323-46. doi: 10.1177/0260106020942967
  65. Cramer RL, McLachlan HL, Shafiei T, et al. Women's experiences of infant feeding support: Findings from a cross-sectional survey in Victoria, Australia. Women Birth. 2021;34(5):e505-e513. doi: 10.1016/j.wombi.2020.09.026
  66. Wu W, Zhang J, Zolezzi SI, et al. Factors influencing breastfeeding practices in China: A meta-aggregation of qualitative studies. Matern Child Nutr. 2021;17(4):e13251. doi: 10.1111/mcn.13251
  67. Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: implementing the revised Baby-friendly Hospital Initiative. World Health Organization, 2018. Available at: Accessed: 21.09.2021

Supplementary files

Supplementary Files
1. Fig. 1. Global Breastfeeding Collective (GBC) 2018 report [31].

Download (100KB)
2. Fig. 2. GBS report 2021 [32].

Download (100KB)
3. Fig. 3. Frequency of exclusive breastfeeding (EBF) of children under 6 months of age worldwide [33].

Download (87KB)
4. Fig. 4. The global incidence of early initiation of BF (1 hour after birth).

Download (84KB)
5. Fig. 5. Distribution of responses (number of children, ordinate axis) to the question about the duration of BF in months (abscissa axis).

Download (64KB)
6. Fig. 6. Comparison of Kaplan-Meier estimates of the duration of BF for the whole period considered (more than 2 years) for primiparous and re-pariparous women (p=0.02).

Download (81KB)
7. Fig. 7. Comparison of Kaplan-Meier estimates of BF duration for the period up to 12 months of lactation for first-born and re-born women (p=0.07).

Download (62KB)
8. Fig. 8. Comparison of Kaplan-Meier estimates of duration of EBF for first and second born women (p=0.24).

Download (74KB)
9. Fig. 9. Dependence of BF duration on maternal age: line – linear regression of duration on age; β – regression coefficient; p – statistical significance.

Download (111KB)
10. Fig. 10. Difference in Kaplan-Meier estimates of the duration of BF over the entire period (up to more than 2 years) for natural childbirth, planned CS, and emergency CS (p=0.76).

Download (86KB)
11. Fig. 11. Difference in Kaplan-Meier estimates of the duration of BF up to 1 year for natural childbirth, planned CS, emergency CS (p=0.041).

Download (70KB)
12. Fig. 12. Difference in Kaplan-Meier estimates of BF duration to 1 year for natural childbirth (cs=0), planned and emergency CS (cs=1) [p=0.016].

Download (68KB)
13. Fig. 13. Differences in Kaplan-Meier estimates of the impact of lactastasis/mastitis, cracked nipples, hypogalactia, other difficulties on the entire duration of the BF (up to 2+ years) [p<0.0001].

Download (106KB)
14. Fig. 14. Differences in Kaplan-Meier estimates of the impact of lactastasis/mastitis, cracked nipples, hypogalactia, other difficulties on the whole period of pregnancy up to 1 year (p<0.0001).

Download (84KB)
15. Fig. 15. Differences in Kaplan-Meier estimates of the impact of care (paediatrician; no referral; gynaecologist; BF consultant) on the duration of EBF (p=0.002).

Download (103KB)
16. Fig. 16. Differences in Kaplan-Meier estimates of the impact of care (paediatrician; did not seek specialist care; gynaecologist; BF consultant) on the duration of the entire BF period (over 2 years) [p=0.00057].

Download (77KB)
17. Fig. 17. Differences in Kaplan-Meier estimates of the impact of care (paediatrician; did not seek specialist care; gynaecologist; BF consultant) on the duration of BF up to 1 year (p=0.00017).

Download (78KB)

Copyright (c) 2021 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies