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Factors Associated with the Duration of Breastfeeding in the Freiburg Birth Collective, Germany (FreiStill).

ABSTRACT: Purpose: The health benefits of breastfeeding for both infants and mothers are well-documented. The aim of this study was to clarify factors associated with successful breastfeeding. Methods: We performed a prospective, multi-centre cohort study of 443 mothers in person using a standardised questionnaire on postpartum day 1. Women who had started to breast-feed were interviewed by telephone after 3, 6 and 12 months. A statistical analysis was performed using the SAS system. Results: 92?% of women (409/443) were initially breastfeeding. After three months the rate decreased to 74?%, after six months to 61?% and after 12 months to 28?%, respectively. Bivariate analysis revealed a significant positive association with the following factors: maternal age >?35 years, higher educational level, intention to breastfeed on postpartum day one, high motivation after three months, partner's support of the decision to breastfeed, satisfaction with the care provided in the maternity clinic, a positive breastfeeding experience and follow-up care by a midwife. Elective caesarean delivery, the use of breastfeeding aids, formula supplementation early on and the mother's concern about the amount of milk correlated negatively. Following a multivariate logistic regression analysis, four factors were correlated with having a positive influence on duration of breastfeeding: higher educational level, satisfaction with the care provided within the maternity clinic, follow-up care by a midwife, and a positive current experience of breastfeeding. Conclusion: Our data demonstrate certain factors successfully influence breastfeeding. Competent care in the maternity clinic, postpartum care by a midwife and a positive experience with breastfeeding increase the rate of breastfeeding and thus have a positive impact on the health of mother and newborn.

SUBMITTER: Rasenack R

PROVIDER: S-EPMC4168329 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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Factors Associated with the Duration of Breastfeeding in the Freiburg Birth Collective, Germany (FreiStill).

Rasenack R R Schneider C C Jahnz E E Schulte-Mönting J J Prömpeler H H Kunze M M

Geburtshilfe und Frauenheilkunde 20120101 1

Purpose: The health benefits of breastfeeding for both infants and mothers are well-documented. The aim of this study was to clarify factors associated with successful breastfeeding. Methods: We performed a prospective, multi-centre cohort study of 443 mothers in person using a standardised questionnaire on postpartum day 1. Women who had started to breast-feed were interviewed by telephone after 3, 6 and 12 months. A statistical analysis was performed using the SAS system. Resu ...[more]

PMID: 25253906

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Project description:ObjectiveTo examine maternal, psychosocial, and pregnancy factors associated with breastfeeding for at least 6 months in those giving birth for the first time.MethodsWe performed a planned secondary analysis of an observational cohort study of 5249 women giving birth for the first time. Women were contacted at least 6 months after delivery and provided information regarding breastfeeding initiation, duration, and exclusivity. Maternal demographics, psychosocial measures, and delivery methods were compared by breastfeeding groups.Results4712 (89.8%) of the women breastfed at some point, with 2739 (58.2%) breastfeeding for at least 6 months. Of those who breastfed, 1161 (24.7% of the entire cohort), breastfed exclusively for at least 6 months. In the multivariable model among those who ever breastfed, not smoking in the month prior to delivery (adjusted odds ratio [aOR] 2.04, 95%CI 1.19-3.45), having a Master's degree of higher (aOR 1.89, 95%CI 1.51-2.36), having a planned pregnancy (aOR 1.48, 95%CI 1.27-1.73), older age (aOR 1.02, 95% CI, 1.01-1.04), lower BMI (aOR 0.96 95% CI 0.95-0.97), and having less anxiety measured during pregnancy (aOR 0.990, 95%CI 0.983-0.998) were associated with breastfeeding for at least 6 months. Compared to non-Hispanic White women, Hispanic women, while being more likely to breastfeed initially (aOR 1.40, 95%CI 1.02-1.92), were less likely to breastfeed for 6 months (aOR 0.72, 95%CI 0.59-0.88). While non-Hispanic Black women were less likely than non-Hispanic White women to initiate breastfeeding (aOR 0.68, 95%CI 0.51-0.90), the odds of non-Hispanic Black women of continuing to breastfeed for at least 6 months was similar to non-Hispanic White women (aOR 0.92, 95%CI 0.71-1.19).ConclusionsIn this cohort of women giving birth for the first time, duration of breastfeeding was associated with several characteristics which highlight groups at greater risk of not breastfeeding as long as currently recommended.Trial registrationNCT01322529 (nuMoM2b) and NCT02231398 (nuMoM2b-Heart Health).

Project description:BackgroundBreastfeeding has the most profound impact on infant health and wellness, and also have significant implications for the mother. The duration of the breastfeeding determines the infant's protection from malnutrition and other common infectious diseases; consequently, the World Health Organization (WHO) recommends exclusive breastfeeding (EBF) six months, followed by gradual weaning and breastfeeding until the baby is two years old. In Pakistan, the practice of breastfeeding is heavily dependent upon certain demographic, economic, social, and biological factors, which ultimately impact the quality of care provided to the infant and their health. The aim of this paper, therefore, is to measure the impact of these factors on the exclusive breastfeeding duration in Pakistan.MethodsThe data for the study has been collected from Pakistan Demographic and Health Survey (PDHS) for the year 2017-18. Binary logistic regression model and survival analysis are used to determine the relationship between the independent and dependent variables.ResultsWe use a binary logistic regression to estimate the effect of each factor on the duration of EBF. The binary logistic regression finds significant relationships between region, maternal education, wealth index, size of a child, watching television, delivery by cesarean, and maternal age and EBF. We then use log-likelihood, AIC, BIC criteria to determine if a parametric or non-parametric model would provide a better fit; based on these results we fit an Inverse Gaussian (Weibull) distribution for the survival analysis. These results show that there are more significant factors associated with EBF duration in parametric survival analysis than in the binary logistic regression results. Thus, the survival analysis is a better method for predicting the relationship between the duration of EBF and its factors. Furthermore, logically EBF is designated to be done for six months which would not be properly gauged with a binary response variable.ConclusionsThe results of this study provide proof that exclusive breastfeeding is a common practice among women in Pakistan, and to improve the quality of post-natal care, health policy in the country needs to focus on the existing demographic and social factors which are found significant in this study.

Dataset Information

Factors Associated with the Duration of Breastfeeding in the Freiburg Birth Collective, Germany (FreiStill).

Publications

Factors Associated with the Duration of Breastfeeding in the Freiburg Birth Collective, Germany (FreiStill).

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