Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother–Child Cohort in Spain

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.

Dificuldades relacionadas ao aleitamento materno: análise de um serviço especializado em amamentação

“…(21,26) Having breastfed other children helps women face the first days of adaptation with the newborn more easily, which favors a long-lasting breastfeeding. (20,21) Regarding women's physical aspects, the present study showed that most women had protruding nipples, a characteristic that was associated with the breastfeeding practice. This finding helps support the evidence that the nipple anatomy can influence the difficulties experienced in the beginning of the breastfeeding period, especially when it is malformed and/or underdeveloped, which usually hinders latch and its maintenance, influencing the practiced type of breastfeeding.…”

“…Studies reported that early weaning is more common among younger women (< 20 years) than among older women (>30 years). (20,21) This divergence may be explained by the higher number of women undergoing exclusive breastfeeding who had already had a breastfeeding experience.…”

Female employees’ perception of breastfeeding‐friendly support in a public university in Spain

“…Creating more breastfeeding‐friendly workplaces is especially important because a recent study in Spain has concluded that a decrease in predominant breastfeeding rates can be partly attributed to women's returning to work. The authors of that study posited that until employers develop policies that encourage breastfeeding, the recommended 6‐month breastfeeding period by WHO is unlikely to be achieved by most working women (Villar et al, ).…”

Combining breastfeeding and work: findings from the Epifane population-based birth cohort

“…Among several determinants, increasing attention has been paid to return to work (RTW) as a major constraint to initiate and continue BF [2][3][4]. Numerous previous studies consistently concluded that RTW before 12-16 weeks, compared with later or not at all, was associated with shorter BF duration [5][6][7][8][9][10][11][12][13][14][15]. Indeed, women themselves mentioned RTW as a reason for stopping BF [16][17][18][19][20], though not in all settings [21,22], probably due to cultural norms and work support backgrounds.…”