Extent of Breastfeeding Challenges Relate to Lower Satisfaction and Success with Breastfeeding Following Term Births in the United States

BACKGROUND: The United States Preventive Services Task Force recommends research to examine how breastfeeding interventions impact emotional well-being. Many interventions aim to mitigate breastfeeding challenges to increase exclusivity and duration; how breastfeeding challenges influence emotional well-being remains poorly quantified. We examined the extent to which breastfeeding challenges relate to breastfeeding satisfaction and success in a U.S. METHODS: We present a secondary analysis of cross-sectional survey data collected in January 2026 from adults with term infants ≤2 years; any postpartum breast pump use; and proficiency in English/Spanish. Recruitment aligned sample demographics with prior national breastfeeding studies. Questions adapted from three Centers for Disease Control and Prevention surveys assessed sociodemographic, health, and breastfeeding factors, including common breastfeeding challenges. An adapted 5-point Likert scale measured breastfeeding satisfaction and success. Ten clinical and community partners reviewed survey content. Eight individuals with pump experience completed cognitive interviews. We used descriptive statistics, unadjusted ordinal logistic regression, and chi-square tests to compare satisfaction and success by any and specific breastfeeding challenges. RESULTS: We included 712 individuals (77% response) from 48 states with a mean (standard deviation) age of 32 years (6.2). Ninety percent reported breastfeeding challenges (median: 2). Each additional breastfeeding challenge heightened one's odds of lower satisfaction (odds ratio [OR] 1.29, 1.17-1.43) and lower success (OR 1.15, 1.05-1.27) on a 5-point Likert scale. Low milk production was related to four- to fivefold lower odds of satisfaction and success. Milk overproduction was related to two- to threefold higher odds of satisfaction and success. CONCLUSION: Breastfeeding challenges were prevalent and associated with lower odds of breastfeeding satisfaction and success.