Mothers’ Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months

Abstract

The aims were to determine Spanish women’s expectations about exclusive breastfeeding (EB) and the effect of expectations and other factors on EB during the first 6 months. A prospective cohort study was conducted with 236 participants. Variables were maternal age, marital status, occupation, expectations about breastfeeding, knowledge about breastfeeding, type of delivery, type of feeding, and duration of EB. Data were collected through three personal interviews, at the hospital (before delivery) and in two telephone calls in the first and sixth months postpartum. Average age was 32.3 years (SD = 5.3); average duration of EB was 2.73 months (SD = 2.49). Of 236 women who had decided to breastfeed before birth, 201 (85.2%) offered EB after delivery. Achievement of expectations was most influenced by the decision to continue breastfeeding ‘as long as I can’ (OR: 5.4; CI: 2.0–14.6) and previous experience (OR: 3.2; CI: 1.2–8.5). Knowledge of breastfeeding acquired from relatives (OR: 9.2; CI: 3.0–27.9), caesarean delivery (OR: 4.6; CI: 1.7–12.8) and maternal age (36–40 years old) (OR: 7.5; CI: 1.8–30.9) were associated with failure to achieve EB. Achievement of EB may depend on a woman’s confidence in her ability to do so and on knowledge obtained in the social environment.

Breastfeeding at 1, 3 and 6 Months after Birth according to the Mode of Birth: A Correlation Study

“…The average age of the study population was 32.16 years, which is in line with the average maternal age in Spain (32.20 years, Spanish Statistics Institute) [ 35 ] and Andalusia (31.68 years) [ 35 ] recorded for the study year 2017. The average duration of breastfeeding was 111.48 days, with an SD of 68.449 days (0–180), which is in agreement with that reported in other studies [ 11 , 12 ]. The evolution of breastfeeding throughout the first six months after birth coincides with the descending trend observed at the Andalusian and Spanish level.…”

“…Other authors have separately analysed spontaneous and induced birth; in this sense, Martínez-Galiano [ 13 ] observed that, in induced birth, the risk of abandonment was 5.6 times greater than in spontaneous births (OR: 5.6, CI95%: 1.107–28.322) [ 13 ]. According to Santacruz-Salas et al [ 11 ], in women who had a caesarean section, breastfeeding failure was 4.6 times greater than in those who had a vaginal birth (OR: 4.6, CI95%: 1.7–12.8) [ 11 ], which is in line with the results reported by other authors, such as Fernández-Cañadas [ 14 ], Brown and Jordan [ 15 ] and Carlander et al [ 16 ]. Other authors have separately studied urgent and programmed caesarean births; with the latter being the one with greater risk of interruption of exclusively breastfeeding with respect to urgent caesarean births [ 17 , 18 , 19 ].…”

“…The present study did not reveal any relationship between maternal age and the prevalence of breastfeeding, which is in line with the results of other studies in the Spanish population [ 23 , 24 ]. However, some studies have found that breastfeeding decreases with maternal age [ 11 , 25 , 26 , 27 ], especially after the age of 35, according to Miñano et al [ 27 ]. Santacruz-Salas et al [ 11 ] asserted that, in women between 36 and 40 years of age, the probability of not meeting their breastfeeding expectations was 7.5 times higher than in women under 25 years of age (OR: 7.5; CI95%: 1.8–30.9) [ 11 ].…”

“…However, some studies have found that breastfeeding decreases with maternal age [ 11 , 25 , 26 , 27 ], especially after the age of 35, according to Miñano et al [ 27 ]. Santacruz-Salas et al [ 11 ] asserted that, in women between 36 and 40 years of age, the probability of not meeting their breastfeeding expectations was 7.5 times higher than in women under 25 years of age (OR: 7.5; CI95%: 1.8–30.9) [ 11 ]. In the present study, the absence of perineal trauma was associated with better results in breastfeeding in the first, third and sixth month after birth.…”

“…In Andalusia, the promotion of breastfeeding, adequate feeding and other healthy habits is included in the Andalusian Primary Healthcare Service [ 9 ] and the Andalusian Integral Plan to Fight Obesity [ 10 ]. Moreover, several studies associate the duration of breastfeeding with factors such as the mode of birth, the age of the mother, parity, education about breastfeeding and epidural analgesia [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Our research hypothesis is that some birth variables influence the type of lactation and the duration of breastfeeding over time.…”