Commentary

The findings by Dye at al that women with unplanned or unwanted pregnancy are less likely to breast feed will come as little surprise to most practitioners. Nevertheless, the study adds credence to existing evidence which indicates that most women who decide to breast feed make their decision before or in early pregnancy.¹ The authors highlight the fact that women with an unplanned or unwanted pregnancy are a vulnerable group who may warrant special attention in relation to breast feeding. However, current evidence fails to identify the most effective means of developing strategies to promote breast feeding. The literature also suggests that efforts to promote breast feeding will prove futile until women are supported in breast feeding their infants for as long as they wish.^{1, 2} It is noteworthy that the study has a public health perspective and consequently has a population based focus. The methods reported, although academically robust, have limitations. As the authors point out, information about breast feeding intent at discharge fails to take into account actual breast feeding behaviour which may differ from what is reported. Although the authors attempt to account for some important confounding variables such as age and education, no attention is paid to other important factors known to influence breast feeding, such as the presence of a supportive partner, employment, and culture. The study informs health and maternity care providers of a group of women who warrant greater attention. Unfortunately, more work needs to be done before any direction can be offered about the most effective means of meeting the needs of these women. The findings of this study also emphasise the importance of strategies to promote preconceptual advice and care for all women.