Abstract
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.
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Acknowledgements
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.
Funding
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.
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Appendix 1
Appendix 1
Criteria that define selected infant feeding practices, according to the World Health Organization’s definitions
Exclusive breastfeeding: breast milk (including milk expressed or from a wet nurse). Allows the infant receive ORS, drops or syrups (vitamins, minerals, medicines). Anything else |
Predominant breastfeeding: breast milk (including milk expressed or from a wet nurse) as the predominant source of nourishment). Allows the infant receive certain liquids (water and water-based drinks, fruit juice) ritual fluids and ORS, drops or syrups (vitamins, minerals, medicines). Anything else (in particular, non-human milk, food-based fluids) |
Breastfeeding: breast milk (including milk expressed or from a wet nurse). Allows the infant receive anything else: any food or liquid including non-human milk and formula |
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Villar, M., Santa-Marina, L., Murcia, M. et al. Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother–Child Cohort in Spain. Matern Child Health J 22, 725–734 (2018). https://doi.org/10.1007/s10995-018-2441-1
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DOI: https://doi.org/10.1007/s10995-018-2441-1