Predictors of exclusive breastfeeding: observations from the Alberta pregnancy outcomes and nutrition (APrON) study

Abstract

BackgroundDespite growing evidence that supports the importance of 6-month exclusive breastfeeding, few Canadian mothers adhere to this, and early weaning onto solids is a common practice. This study assessed infant feeding transitions during the first 6 months postpartum and factors that predicted exclusive breastfeeding to 3 and 6 months.MethodsThis prospective cohort study was part of the Alberta Pregnancy Outcomes and Nutrition study (APrON). From an initial sample of 600 pregnant women recruited from Edmonton and Calgary, 402 mothers provided complete details at 3 months postpartum; 300 stayed on to provide information at 6 months postpartum. During pregnancy and at 3 and 6 months postpartum, data on maternal and infant socio-demographic, behavior, and feeding were collected.ResultsEven though there was a high rate of “ever having breastfed” (98.6%), exclusive breastfeeding rates for 3 and 6 months were 54.0% and 15.3%, respectively. After controlling for potential confounders, the study showed that mothers who held post-graduate university degrees were 3.76 times more likely to breastfeed exclusively for 6 months than those without a university degree (95% CI: 1.30-10.92; p = 0.015). In addition, mother of previous children were more likely to breastfeed exclusively for 6 months (OR: 2.21, 95% CI: 1.08-4.52; p = 0.031). Mothers who were in the highest quartile of the Iowa Infant Feeding Attitude Score were 4.29 and 5.40 times more likely to breastfeed exclusively for 3 months (95% CI: 1.31-14.08; p-trend < 0.001) and 6 months (95% CI: 2.75-10.60; P-trend < 0.001), respectively.ConclusionsThe 6-month exclusive breastfeeding rate in Alberta is considerably below national and international breastfeeding recommendations. Professional advice that focuses on prenatal maternal knowledge, attitudes, and misperceptions may promote adherence to World Health Organization breastfeeding guidelines. Knowing that exclusive breastfeeding is less likely to take place among lower-educated, primiparous women may help health practitioners focus their support and education for this group.

Associations of Breastfeeding Knowledge, Attitude and Interest with Breastfeeding Duration: A Cross-sectional Web-based Study

“…Interestingly, we found that the paternal role, foods to avoid, body change in mothers, mothers' health and methods to prolong breastfeeding would be important elements for the development of web-based educational information program. These findings agree with those of previous studies on the association between knowledge and attitudes toward breastfeeding [8,9,23].…”

“…Also, previous studies have shown that maternal knowledge and attitudes toward breastfeeding may influence the personal decision and intention to breastfeed as well as the duration of breastfeeding [8,9].…”

Acompanhamento fonoaudiológico do aleitamento materno em recém-nascidos nas primeiras horas de vida

“…Currently, there are numerous breastfeeding promotion campaigns that seek support for mothers and their families from the prenatal period. Direct interventions with the dyads at the beginning of lactation have been shown to be fundamental for a longer duration of this practice (1,8,9) . However, early weaning rates are still alarming in developing countries (10) .…”

“…Breastfeeding is a natural act; however, breastfeeding may not be simple for some women, because it depends on both the mother-newborn's clinical and anatomical conditions and the meaning that mothers attribute to the breast, body, infant, act breastfeeding and economic, social and cultural circumstances (1,2) . In phonoaudiological terms, breastfeeding facilitates the adequate growth and development of the structures that forms the stomatognathic system and its functions of respiration, suction, swallowing, chewing and speech (3) .…”

“…The identification of the risk factors for failure to breastfeed contributes to the definition of behaviors to be used in the management, as well as to delimit which specific knowledge is important to be emphasized among the population (3) . The literature refers to studies carried out with the aim of identifying risk factors for breastfeeding, discussing aspects involving anatomy (3,9,14) , physiology (1,3,9,11,14) , social and cultural issues (1,3,10,14,15) . However, the effects of the speech-language interventions performed through the follow-up of the breastfeeding in the mother-RN dyads have not been discussed.…”