Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis

Abstract

Objective To use a quantitative approach to evaluate the literature for quantity, quality, and consistency of studies of maternal and infant characteristics in association with breastfeeding initiation and continuation, and to conduct a meta-analysis to produce summary relative risks (RRs) for selected factors.Study design A systematic review using PubMed and CINAHL through March 2016 was conducted to identify relevant observational studies in developed nations, reporting a measure of risk for 1 or more of 6 quantitatively derived, high impact factors in relation to either breastfeeding initiation or continuation. One author abstracted data using a predesigned database, which was reviewed by a second independent author; data evaluation and interpretation included all co-authors. These factors were summarized using standard metaanalysis techniques. ResultsSix high impact factors were identified (smoking [39 papers], mode of delivery [47 papers], parity [31 papers], dyad separation [17 papers], maternal education [62 papers], and maternal breastfeeding education [32 papers]). Summary RR from random-effects models for breastfeeding initiation were highest for high vs low maternal education (RR 2.28 [95% CI 1.92-2.70]), dyad connection vs not (RR 2.01 [95% CI 1.38-2.92]), and maternal nonsmoking vs smoking (RR = 1.76 [95% CI 1.59-1.95]); results were similar for breastfeeding continuation.Conclusions Despite methodological heterogeneity across studies, relatively consistent results were observed for these perinatally identifiable factors associated with breastfeeding initiation and continuation, which may be informative in developing targeted interventions to provide education and support for successful breastfeeding in more families. (J Pediatr 2018;203:190-6). P-h P value for heterogeneity RR Relative risk SES Socioeconomic status WIC Women, infants, and children From the

Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners

“…Consequently, the duration of time that mother's breastfed exclusively in this study was significantly lower than the recommendation of 6 months by WHO. The reasons for this might be multifactorial [10,11,27,33]. Certain changes in Sweden in recent decades may have affected mothers who want to breastfeed and contributed to less incidences of breastfeeding.…”

“…Several factors are associated with shorter period of breastfeeding, for instance, being a first-time mother, emotional distress during pregnancy, separation between infant and mother and giving birth by caesarean section [10][11][12]. There are also differences in the duration of breastfeeding due to sociodemographic factors such as age and socioeconomic status [13].…”

Validation of the Breastfeeding Score—A Simple Screening Tool to Predict Breastfeeding Duration

“…The four included risk factors in the breastfeeding score represented different domains of the multifactorial structure of breastfeeding. Level of completed education contributed with information on maternal sociodemographic background, well-known to influence breastfeeding duration [6]. Previous breastfeeding experience contributed with information on the pre and perinatal period, including first time motherhood and the success of breastfeeding for the multiparous mother expressed by the duration of exclusive breastfeeding of the previous child.…”

“…Successful breastfeeding depends on multiple factors [6][7][8], and a tool to predict breastfeeding duration should therefore include different kinds of indicators. The challenge is still to establish a link from the risk profile of predictors for early cessation of breastfeeding to a practical tool (index) providing valid information for professionals to initiate preventive efforts.…”

Introductory Chapter: A Comprehensive Approach to the Process of Breastfeeding

“…One review recently highlighted high impact factors such as smoking, mode of delivery, parity, separation of the mother-child dyad, maternal education, and maternal education on breastfeeding [13]. As an example, women who graduated from high school or higher educational institutions received education regarding breastfeeding, breastfeed within 1 hour after birth, and did not work had significantly higher rates of exclusive breastfeeding at 6 months.…”