Determinants of Breastfeeding Practices and Success in a Multi‐Ethnic Asian Population

Pang, Wei Wei; Aris, Izzuddin M.; Fok, Doris; Soh, Shu‐E; Chua, Mei Chien; Lim, Sok Bee; Saw, Seang‐Mei; Kwek, Kenneth; Gluckman, Peter D.; Godfrey, Keith M.; Dam, Rob M. van; Kramer, Michael S.; Chong, Yap Seng

doi:10.1111/birt.12206

Cited by 50 publications

(59 citation statements)

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“…Similarly, Pang et al conducted a cohort study involving 1030 Singaporean women in early pregnancy and found that the prevalence of breastfeeding at 6 months postpartum varies among the different ethnic groups even after adjusting for maternal education [16]. In our study, we found similar prevalence (79.1% vs 79.9%) of breastfeeding at 5 to 9 weeks postpartum as compared to the National Breastfeeding Survey in 2011 [1].…”

Section: Discussionsupporting

confidence: 77%

Investigating factors associated with success of breastfeeding in first-time mothers undergoing epidural analgesia: a prospective cohort study

et al. 2018

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BackgroundWe investigated the possible risk factors that could influence the likelihood of breastfeeding at 5 to 9 weeks postpartum with our primary aim being to analyse the associations between psychological vulnerabilities, such as peripartum depression and anxiety, and continued breastfeeding. Our secondary aim was to investigate other non-psychological factors’ influence on continued breastfeeding.MethodsA prospective cohort study was conducted in KK Women’s and Children’s Hospital in Singapore. Healthy nulliparous parturients at ≥36 weeks gestation with a singleton fetus who received epidural analgesia were recruited. Demographic and anaesthetic data were obtained. Self-reported psychological and pain determinants such as anxiety (State-Trait Anxiety Inventory), depression (Edinburgh Postnatal Depression Scale), stress (Perceived Stress Scale), pain susceptibility (Pain Catastrophizing Scale) and pain perception (McGill Pain Questionnaire) were also recorded at baseline. A phone interview was then performed at 5 to 9 weeks postpartum to obtain information on breastfeeding status.Results329 participants were included into this study, of which 263 (79.9%) of them were still breastfeeding at 5 weeks postpartum. Multivariate logistic regression analysis showed that a higher State-Trait Anxiety Inventory score (Adjusted Odds Ratio [AOR] 0.97; 95% Confidence Interval [CI] 0.94, 1.00) at baseline, higher intrapartum blood loss (AOR 0.76; 95% CI 0.61, 0.93), and occurrence of fetal anomalies (AOR 0.15; 95% CI 0.03, 0.72) were associated with reduced likelihood of breastfeeding at 5 to 9 weeks postpartum. Indians (AOR 0.56; 95% CI 0.20, 1.53), Malays (AOR 0.30; 95% CI 0.14, 0.62) and other ethnicities (AOR 0.36; 95% CI 0.16, 0.83) were less likely to continue breastfeeding compared to Chinese participants. On the other hand, receiving any support services on breastfeeding during the participants’ hospital stay was 3.3 times more likely (AOR 3.30; 95% CI 1.21, 9.02) to increase the likelihood of breastfeeding at 5 to 9 weeks postpartum.ConclusionWe identified 5 independent association factors that could have significant influences on breastfeeding at 5 to 9 weeks postpartum. Healthcare providers could utilize this risk stratification to identify parturients likely to have poorer breastfeeding outcomes and undertake interventions that may help safeguard optimization of breastfeeding outcomes and parturient care.Trial registrationClinicaltrials.gov NCT02278601. Registered 26 October 2014.Electronic supplementary materialThe online version of this article (10.1186/s13006-018-0184-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 77%

Investigating factors associated with success of breastfeeding in first-time mothers undergoing epidural analgesia: a prospective cohort study

et al. 2018

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“…We have previously reported that breast milk expression is common in the multi-ethnic Asian Singapore population [15]. While the majority of mothers who fed their infants expressed breast milk also fed their infants directly at the breast, we found that a substantial proportion of mothers fed their infants expressed breast milk exclusively at three months postpartum and beyond.…”

Section: Introductionmentioning

confidence: 47%

Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding

et al. 2017

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Background: Studies examining direct vs. expressed breast milk feeding are scarce. We explored the predictors of mode of breastfeeding and its association with breastfeeding duration in a multi-ethnic Asian population. Methods: We included 541 breastfeeding mother—infant pairs from the Growing Up in Singapore Toward healthy Outcomes cohort. Mode of breastfeeding (feeding directly at the breast, expressed breast milk (EBM) feeding only, or mixed feeding (a combination of the former 2 modes)) was ascertained at three months postpartum. Ordinal logistic regression analyses identified predictors of breast milk expression. Cox regression models examined the association between mode of breastfeeding and duration of any and of full breastfeeding. Results: Maternal factors independently associated with a greater likelihood of breast milk expression instead of direct breastfeeding were Chinese (vs. Indian) ethnicity, (adjusted odds ratio, 95% CI; 3.41, 1.97–5.91), tertiary education (vs. secondary education or lower) (2.22, 1.22–4.04), primiparity (1.54, 1.04–2.26) and employment during pregnancy (2.53, 1.60–4.02). Relative to those who fed their infants directly at the breast, mothers who fed their infants EBM only had a higher likelihood of early weaning among all mothers who were breastfeeding (adjusted hazard ratio, 95% CI; 2.20, 1.61–3.02), and among those who were fully breastfeeding (2.39, 1.05–5.41). Mothers who practiced mixed feeding, however, were not at higher risk of earlier termination of any or of full breastfeeding. Conclusions: Mothers who fed their infants EBM exclusively, but not those who practiced mixed feeding, were at a higher risk of terminating breastfeeding earlier than those who fed their infants directly at the breast. More education and support are required for women who feed their infants EBM only.

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“…Ethnicity has been pointed out as a significant predictor of how breastfeeding is performed in large continents such as Asia or Africa [16,17]. Thus, within the limitations of the present study, we have found explanatory variables that have been discussed in the EBF practice, but larger studies can increase knowledge in this area.…”

Section: Variablesmentioning

confidence: 68%

“…This loss was greater than that found in the present study; however, the follow-up was performed for a longer period. The difference among studies published in Brazil and worldwide regarding the loss of participants is directly related to the type of study proposed by the authors, the form of interviews (telephone contact or home visit) and the time participants were followed, which indicates that the longer the study period, the greater the sample loss percentage [12,13,15,16].…”

Section: Variablesmentioning

confidence: 99%

Factors Related to the Practice of Exclusive Breastfeeding in Different Cities of the States Minas Gerais and Bahia, Brazil

Bomfim

Novaes²,

Bonanato³

et al. 2017

Pesqui. bras. odontopediatria clín. integr.

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Objective: To evaluate the factors related to the time of exclusive breastfeeding (EBF) in infants from Pará de Minas and Três Corações (Minas Gerais) and Brumado (Bahia), Brazil. Material and Methods: All mothers attended in public and private hospitals of these cities between June and December 2012 (n=156) were invited to answer an interview related to EBF. Data were collected: (1) at maternity ward; (2) at 4 and (3) 6 months of the infant's life. In (2) and (3), data were collected by phone. Data were recorded in the SPSS software, and descriptive analyses and association of exposure and outcome variables related to the practice of EBF were performed. The chi-square test was used, considering p <0.05. Results: The total of women was in (1) 156, (2) 104 and (3) 123, and the EBF rate was 50.0%, 39.0% and 4.8%, respectively. In (1) mothers with lower schooling level have opted for EBF more frequently. In (1), the use of bottle did not interfere in EBF; on the other hand, in (2) and (3), the use of bottle has decreased the frequency of EBF (p < 0.05). Conclusion: The ideal frequency of EBF recommended by WHO to the six months of the infant's life is not followed in the evaluated cities. In addition, EBF can be influenced by the use of bottle and maternal schooling level.

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Determinants of Breastfeeding Practices and Success in a Multi‐Ethnic Asian Population

Cited by 50 publications

References 34 publications

Investigating factors associated with success of breastfeeding in first-time mothers undergoing epidural analgesia: a prospective cohort study

Investigating factors associated with success of breastfeeding in first-time mothers undergoing epidural analgesia: a prospective cohort study

Direct vs. Expressed Breast Milk Feeding: Relation to Duration of Breastfeeding

Factors Related to the Practice of Exclusive Breastfeeding in Different Cities of the States Minas Gerais and Bahia, Brazil

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