Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study*, 1993–1999

Abstract

The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at‐risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24–48 h after birth and a follow‐up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer‐Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26–2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58–6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79–4.21), the first mother‐child contact occurring after 90min of life (OR =1.88; 95% CI 1.22–2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05–2.15). The calibration of the model was acceptable in the CLACYD I sample (p= 0.54), as well as in the CLACYD II sample (p= 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.

Effects of unplanned pregnancy on neonatal health in Turkey: A case–control study

“…also reported that unwanted pregnancy decreased breast‐feeding 29 . There have been other studies showing that breast‐feeding was discontinued earlier in babies born to women with unplanned pregnancy 16,30 …”

How to achieve long-term breast-feeding: factors associated with early discontinuation

“…Other studies report that type of birth may be associated (33)(34)(35) , may not be associated (6,7,23) or may be weakly associated (36) with breast-feeding duration.…”

Fertility intentions and child health in India: Women’s use of health services, breastfeeding, and official birth documentation following an unwanted birth

“…For example, studies from the United States have found that children resulting from unwanted births were less likely than those identified as wanted to be breastfed [8][9][10][11][12][13]. Additionally, studies from low-income countries in South America and West Africa have shown that compared to women who reported their births were wanted, women with unwanted births had lower likelihoods of breastfeeding and continuing to breastfeed [14][15][16][17]. Fertility intentions are also associated with several distinct indicators of child health across contexts, including higher rates of childhood illness [18], low birthweight [9,19], stunting [20][21][22], and infant mortality [21,23,24].…”