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The effects of maternal exposure to second-hand smoke on breast-feeding duration: A prospective cohort study

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Abstract

Aim

Encouraging exclusive breastfeeding up to 6 months is one of the main priorities for public health. However, the rate of exclusive breastfeeding is decreasing in Iran. Moreover, there have been few studies conducted on the effects of maternal exposure to cigarette smoke on breastfeeding duration in Iran. Considering the importance of breast milk for infant development, the future health of the baby and ultimately the family, this study was designed to assess the effect of maternal exposure to second-hand smoke on exclusive breastfeeding duration.

Subjects and methods

The effect of smoke exposure on exclusive breastfeeding was investigated in a prospective cohort study. The study included 170 mothers in the exposed group and 170 mothers in the non-exposed group. There were losses to follow-up (12 %), so a statistical analysis was carried out on a total of 299 women. Breastfeeding duration and maternal exposure to second-hand smoke were recorded in three follow-up interviews, including 3–5 days, 3 months and 6 months after delivery. Maternal exposure to second-hand smoke was assessed by self-reports. A Kaplan-Meier survival analysis and Cox regression model were used for data analysis.

Results

Maternal exposure to second-hand smoke during the postpartum period can cause a significant reduction in exclusive breastfeeding during a 6-month period (p < 0.001). According to the Cox regression model, heavily exposed (hazard ratio = 2.22, 95 % confidence interval: 1.45–3.39) and lightly exposed mothers (hazard ratio = 1.65, 95 % confidence interval: 1.25–2.42) were more likely to stop exclusive breastfeeding earlier compared with non-exposed women.

Conclusion

Maternal exposure to second-hand smoke is associated with an increased risk of discontinuation of exclusive breastfeeding before 6 months. A stance of no smoking at home and avoidance of passive smoking could possibly improve the rate of breastfeeding in Iran.

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Acknowledgements

This study was part of a MSc thesis supported by Tehran University of Medical Sciences (TUMS); grant No. 89-03-28-11484. We would like to thank all the participants in this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Contribution

All the authors contributed to the conception and design of the study. AB and SN oversaw the collection, analysis and interpretation of data. Data collection was done by FG and data analysis was done by ARF. FG drafted the first version of the manuscript. AB, ARF and SN revised the manuscript. AB critically reviewed the manuscript for important intellectual content. All authors approved the final version.

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Authors and Affiliations

  1. Department of Reproductive Health, Tehran University of Medical Sciences, Tohid Sq, Nosrat Street, Tehran, Iran

    Azam Baheiraei

  2. Community-Based Participatory Research Center, Tehran University of Medical Sciences, Tohid Sq, Nosrat Street, Tehran, Iran

    Azam Baheiraei

  3. Department of Maternal and Child Health, Tehran University of Medical Sciences, Tohid Sq, East Nosrat Street, Tehran, Iran

    Faezeh Ghafoori

  4. Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Enghelab Sq, Azadi Street, Tehran, Iran

    Abbas Rahimi Foroushani

  5. School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Enghelab Sq, Azadi Street, Tehran, Iran

    Saharnaz Nedjat

Authors
  1. Azam Baheiraei
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  2. Faezeh Ghafoori
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  3. Abbas Rahimi Foroushani
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  4. Saharnaz Nedjat
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Corresponding author

Correspondence to Faezeh Ghafoori.

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Baheiraei, A., Ghafoori, F., Rahimi Foroushani, A. et al. The effects of maternal exposure to second-hand smoke on breast-feeding duration: A prospective cohort study. J Public Health 22, 13–22 (2014). https://doi.org/10.1007/s10389-013-0589-0

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  • DOI: https://doi.org/10.1007/s10389-013-0589-0

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