Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother–Child Cohort in Spain
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Objective The aim of the study was to identify factors associated with non-initiation and cessation of predominant breastfeeding (PBF) in a mother–child cohort from Spain. Materials and Methods The analysis included 2195 mother-infant from birth to 14 months post- delivery recruited between 2004 and 2008. Maternal characteristics were collected during the pregnancy. Lactation data were obtained at 6 and 14 months after delivery. PBF was defined as intake of breast milk plus liquids like juices or water. The PBF cessation was calculated using the date that women started PBF and the date that she reported to start giving infant formula and/or food. The relationship between maternal variables and PBF initiation and cessation was modeled using logistic and Cox proportional hazards regression analysis. Results The prevalence of PBF at hospital discharge was 85.3, 53.4% at 3 months, 46.1% at 4 months and 7.2% at 6 month. Only two women continued PBF at 12 months and none at 14 months. The initiating of PBF was associated with higher levels of maternal education, being a first-time mother and worked in a non-manual occupation. Higher level of physical activity, not smoking and having a healthy BMI, were also positively associated with PBF initiation. PBF cessation was higher in young, obese women, who had had complications during the pregnancy, and who had lower levels of education and smoked. The employment status of women, in week 32 of pregnancy and also in month 14 post-delivery, determined likelihood of PBF cessation. Conclusions Healthier habits and education positively influenced PBF initiation and duration. Decrease in PBF duration rates in Spain can be interpreted in part as a consequence of women returning to work.
KeywordsBreastfeeding Predominant breastfeeding Socioeconomic factors Life style
The authors would particularly like to thank to the INMA families for their contribution in the study. The authors are grateful to all fieldworkers for their assistance in contacting the families and administering the questionnaires. A full listing of the INMA project researchers can be found at: http://www.proyectoinma.org/presentacioninma/listadoinvestigadores/en_listadoinvestigadores.html.
This study was funded by Grants from Instituto de Salud Carlos III and Spanish Ministry of Health (Red INMA G03/176; CB06/02/0041; FIS 97/0588; 00/0021-2, PI061756; PS0901958; FIS-FEDER 03/1615, 04/1509, 04/1112, 04/1931, 05/1079, 05/1052, 06/1213, 07/0314 and 09/02647; FIS-PI041436, FIS-PI081151, FIS-PI06/0867 and FIS-PS09/00090), Conselleria de Sanitat Generalitat Valenciana, Generalitat de Catalunya-CIRIT 1999SGR 00241, Department of Health of the Basque Government (2005111093 and 2009111069), the Provincial Government of Gipuzkoa (DFG06/004 and DFG08/001), and Fundación Roger Torné.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- Fein, S. B., Mandal, B., & Roe, B. E. (2008). Success of strategies for combining employment and breastfeeding. Pediatrics, 122(Suppl 2), S56-S62.Google Scholar
- Instituto Nacional de Estadística (2014). Anuario Estadístico de España. 2014. Nivel, calidad y condiciones de vida.Google Scholar
- Instituto Nacional de Estadística (INE) (2011). Encuesta Nacional de Salud de 2011/2012 (ENSE 2011/2012). http://www.msssi.gob.es/estadEstudios/estadisticas/encuestaNacional/encuesta2011.htm. Accessed on November 19, 2012
- Julvez, J., Guxens, M., Carsin, A. E., Forns, J., Mendez, M., Turner, M. C., et al. (2014). A cohort study on full breastfeeding and child neuropsychological development: The role of maternal social, psychological, and nutritional factors. Developmental Medicine & Child Neurology, 56, 148–156.CrossRefGoogle Scholar
- Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews, 8, CD003517.Google Scholar
- Lange, C., Schenk, L., & Bergmann, R. (2007). Distribution, duration and temporal trend of breastfeeding in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, 50, 624–633.CrossRefPubMedGoogle Scholar
- World Health Organization, UNICEF, IFPRI, UCDavis, FANTA, AED et al. (2008). Indicators for assessing infant and young child feeding practices: Conclusions of a consensus meeting held 6–8 November 2007 in Washington D.C.Google Scholar
- World Health Organization & UNICEF (2007). Planning Guide for national implementation of the Global Strategy for Infant and Young Child Feeding. Report of a WHO study group.Google Scholar