Abstract
BackgroundSuccessful breastfeeding often starts with prenatally established intention. Yet, few mothers with the intention to exclusively breastfeed achieve their intended breastfeeding duration goal. This study examined the degree to which having a strong value of exclusive breastfeeding is associated with exclusive breastfeeding duration for at least 3 and 6 months postpartum among women who reported prenatal intention to exclusively breastfeed.MethodsData were from the Infant Feeding Practices Study II, a longitudinal US national survey that followed maternal-infant dyads from pregnancy to 1 year postpartum. Bivariate and multivariate regression examined the degree to which strong maternal value of exclusive breastfeeding predicted exclusive breastfeeding duration.ResultsOf the 1799 women who prenatally intended to exclusively breastfeed within the first few weeks postpartum, 34 and 9 % exclusively breastfed for at least 3 months and 6 months, respectively. Thirty-six percent of women reported strongly valuing exclusive breastfeeding out of which 46 % exclusively breastfeed to three months. In adjusted results, women who reported that they strongly value exclusive breastfeeding had more than twice the odds of exclusive breastfeeding for at least 3 months (Adjusted Odds Ratio [AOR] 2.29; 95 % confidence interval [CI] 1.84, 2.85) and for 6 months (AOR 2.49; 95 % CI 1.76, 3.53) compared to those who did not strongly value exclusive breastfeeding.ConclusionValuing the benefits of exclusive breastfeeding during pregnancy is a strong independent predictor of actual exclusive breastfeeding duration. A minority of pregnant women strongly value exclusive breastfeeding and are able to exclusively breastfeed to 3 months even among women with established prenatal intention to exclusively breastfeed. Prenatal maternal education and environmental lactation support that extends into the postnatal period can promote longer duration of exclusive breastfeeding.
Highlights
Successful breastfeeding often starts with prenatally established intention
We examined exclusive breastfeeding duration to both 3 months and 6 months as we expected that fewer mothers would exclusively breastfeed to 6 months, which would limit the power of the analysis
This study highlights the importance of the duration of exclusive breastfeeding and adds to our understanding of maternal personal factors that promote exclusive breastfeeding. This was a secondary analysis of the United States Infant Feeding Practices Study II (IFPS II), a longitudinal survey of mothers of healthy singleton pregnancies conducted by the Food and Drug Administration (FDA) in collaboration with the Centers for Disease Control and Prevention (CDC) [27]
Summary
Successful breastfeeding often starts with prenatally established intention. Yet, few mothers with the intention to exclusively breastfeed achieve their intended breastfeeding duration goal. A relatively small percentage of women breastfeed exclusively as recommended and the proportion of infants who are exclusively breastfed for 6 months after birth has increased at a much slower rate compared to that of infants who receive mixed feeding [3, 4] Reasons for this slow improvement among mothers in the United States include: (a) breastfeeding has not received sufficient national attention as a public health issue [5]; (b) inadequate attention to the importance of the duration of exclusive breastfeeding [3, 6]; and (c) inadequate research addressing exclusive breastfeeding in the United States [3, 7]. The highest exclusive breastfeeding rates are reported in eastern and southern regions in Africa (51 %) [9]
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