Breastfeeding is the recommended feeding for all healthy infants. The aim of our study was to assess the current state of breastfeeding prevalence, duration and behaviour in Bavaria, Germany as a basis for targeting breastfeeding promotion measures. The Bavarian Breastfeeding Study is a prospective cohort study of 3822 mothers who delivered in April 2005 in Bavaria, Germany. Breastfeeding duration and determinants such as socioeconomic status, attitudes towards breastfeeding, birth mode and breastfeeding problems were assessed by questionnaires 2 -6 d after birth and 2, 4, 6, and 9 months after birth. The initial breastfeeding rate was 90 %. After 4 months 61 % still breastfed (any breastfeeding). In the multivariate analyses the main influencing factor reducing breastfeeding initiation was the partner's negative attitude towards breastfeeding (OR 21·79; 95 % CI 13·46, 35·27). No initial breastfeeding was also associated with lower education, maternal grandmother's negative attitude and pre-term birth. Protective factors were primary breastfeeding experience and information on breastfeeding before birth. Breastfeeding duration , 4 months was strongly associated with breastfeeding problems (OR 7·56; 95 % CI 6·21, 9·19), smoking, lower education, partner's negative attitude and Caesarean section. Since the attitude of family members is an important influencing factor on breastfeeding rates, breastfeeding promotion should also target the partners of pregnant women and the families of newborn infants. Public health interventions such as more effective support for the management of breastfeeding problems, especially in lower social status families, should be implemented and their effectiveness should be critically evaluated. Breastfeeding: Infant nutrition: Breast milkBreastfeeding is the recommended feeding for healthy infants. Three recent meta-analyses indicate that breastfeeding protects against gastrointestinal and to a lesser extent also other infections and provides a variety of other health benefits (1 -3) , including a reduced risk of later overweight or obesity (4,5) . In 1981 breastfeeding initiation rates in two German cities were between 87 and 95 %, and only 2-6 % of infants were still fully breastfed at 4 months of age (6) . The main reason why mothers ceased breastfeeding early was breastfeeding problems. In 1997 breastfeeding initiation rates were reported as about 91 % (7)

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Further improvements in nutrition of infants may be achieved in 2 ways: promotion of breast-feeding according to current recommendations and better counselling on the correct timing of introduction of semisolid food-especially for parents of not- or short-time breast-fed babies and focused on young mothers with low levels of education.

Action is needed along the whole causal pathway of the social divide in environmental hazards with priority to policy measures aiming at removing socially determined differences in environmental conditions.

Differences in child growth depending on breastfeeding duration should be investigated further. Concerning health outcomes our findings support the recommendation for > or =6 months of exclusive breastfeeding.