Sociopsychological determinants of women's breast-feeding behavior: A replication and extension.

Abstract

Women's birth experience, studied in two time periods, had negligible impuct on their persistence in breast-feeding, nor did early postpartum experience, type of feeding regimen, or timing of solid food introduction emerge as significunt correlates. Women's prenatal intentions were the strongest predictor of breast-feeding success in the first month, and the mother's own history of having been breast-fed us an infant appears to be a predisposing factor. The influence of socioeconomic factors and childbirth preparation classes ure examined. A revised Lzersion of (I ptrper siibmitted to the Joitrnirl in Jirne1980. Resecirch w w s siipported by (I Grrggenheim Fellowship t o Doris Entwisle cind by NIMH grunts MH2S172. MHI2S25. cind NICHD gront 13103. One of the ciiithors (Doering) is now (it Environmentcil Progrcims. Inc.. Btiltimore.

Breastfeeding duration: prenatal intentions and postnatal practices

“…The hypothesis regardmg prenatal intent was only partially supported Intended duration of breastfeedmg was found to be a discnmmating factor supportmg previous research (Buxton et al 1991, Conel & Murphy 1988, Entwisle et al 1982, Loughlin et al 1985, O'Campo et al 1992, however, commitment score and total confidence score were not found to be significant…”

“…The failure of confidence as a predictor of breastfeeding duration supports the importance of considermg pnmiparas as a separate population Only Entwisle et al (1982) completed their study with pnmiparas, and confidence was not mcluded as a component m their definition of prenatal intent Others (Buxton et al 1991, Coriel & Murphy 1988, Loughlm et al 1985, O'Campo et al 1992 had subject pools combining both pnmiparas and multiparas In the present study, while confidence m ability to overcome problems was significantly related to planned duration of feeding, confidence was not itself a predictor of feedmg at 12 weeks It appears that while confidence based on a previous expenence may predict success it is not an indicator of breastfeedmg duration for those having their first child Having a high commitment level to carry through with the breastfeeding decision has only been measured in relation to breastfeeding duration by Buxton et al (1991) The fact that the duration of breastfeeding measured m this study was only 1 week and that they did not exclusively measure pnmiparas could account for the different result In the present study, only two women were not breastfeeding after 1 week Identifying those who establish breastfeeding but then partly or totally abandon it with 12 Table 3 Means and standards deviations of significant predictor variables of breastfeeding status at 12 weeks Intended duration and atUtude to formula are rated on a six-point scale Higher scores indicate an intention to breast feed for a longer period and more negative attitudes to formula feeding Tuning of decision to breastfeed, hours m care of others and education are rated on a four-point scale, with higher values mdicating higher levels of education, later timing of decision to feed and longer hours in the care of others Timing of first breastfeed is rated on a three-point scale, with higher values indicating more hours after birth before fixst feed weeks of birth appears related not to mothers' confidence but to when she decided on breastfeeding, how long she planned to feed for and how negative she felt about the use of fonnula While over 90% of subjects planned to feed beyond 4 months, abandoning or reducing breastfeeding earlier may be less of an attitude shift to those who planned to put their baby on fonnula at some stage rather than feedmg until the baby could be weaned on cows milk…”

“…Breastfeeding duration has been shown to be predicted by a range of measvires of prenated intentions and attitudes Between 50% eind 90% of expectant mothers decide how they will feed their child either before falling pregnant or very early in pregnancy (Bailey & Shemff 1992, Dix 1991 If there is a degree of ambivalence expressed about whether to breastfeed or not during pregnancy, then the likelihood of weanmg m the early weeks after birth is greatly increased (Hood ef al 1978) Studies measunng breastfeeding duration from 1 week (Buxton et al 1991) to 25 weeks (O'Campo et al 1992) have consistently found that intended duration and a mother's confidence m her ability to breastfeed are significant predictors in breastfeeding duration (Buxton et al 1991, Conel & Murphy 1988, Loughlin et al 1985, O'Campo et al 1992 A woman who rates her confidence as very high will more than likely achieve her stated goal or come very near it, regardless of the type of birth she has (Janke 1988) or the postnatal difficulties she encounters (Rentschler 1991) A negative attitude to artificial feeding (Entwisle et al 1982) £md being strongly committed to obtainmg a breastfeeding goal (Buxton et al 1991) have also been found to be significant prenatal variables in relation to breastfeeding duration Previous feeding experience has shown to powerfully influence whether an infant is breastfed If a mother breastfeeds her first child, most will repeat this decision with subsequent children, while those who artificially feed will repeat that decision (Bruce et al 1991) This continuity in feeding behaviour suggests the importance of distmguishing primiparas fi'om other expectant mothers in developing predictors of feeding success…”

Determinants of breastfeeding in four Canadian Ojibwa communities: A decision-making model

“…In the decision-making model, prenatal intent was a strong predictor of breastfeeding initiation. This finding concurs with previous studies (Entwisle et al, 1982;Coreil and Murphy, 1988). Less than one-quarter of the women had decided how to feed their babies before pregnancy.…”

Gender role attitudes and other determinants of breast feeding intentions in Brazilian women

“…Only after the contingent variables are known, can health professionals plan a course of action to stimulate breastfeeding. Studies have repeatedly shown that the length of time for which a woman intends to breast feed is a very good predictor of her behaviour (Becke & Garvis 1982; Entewisle et al 1982; Richardson & Champion 1992). Until actual breast feeding duration is investigated, research concerning the variables associated with intentions can help identify women most at risk for early abandonment of breast feeding.…”