Abstract

Breastfeeding is the normative standard for infant feeding. Despite its established benefits, different factors can affect breastfeeding rates over time. The purpose of this study was to evaluate breastfeeding determinants in healthy term newborns during the first three months of life. A prospective, observational, single-center study was conducted in the nursery of Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico in Milan, Italy. The mother-baby dyads that were admitted to the Clinic in January and February 2017 were enrolled. Only healthy term babies with birth weight ≥10th percentile for gestational age were included. Data were collected through medical records and questionnaires administered during the follow-up period. Then, we fitted univariate and multivariate logistic models and calculated odds ratios. 746 dyads were included but 640 completed the study. The factors found to be favoring breastfeeding were a previous successful breastfeeding experience, a higher level of education of the mother, attending prenatal classes, no use of pacifier, rooming in practice, and breastfeeding on demand. Factors acting negatively on breastfeeding were advanced maternal age, non-spontaneous delivery, perception of low milk supply, mastitis, and nipple fissures. This study highlights the need to individualize the assistance provide to breastfeeding mothers, paying special attention to personal experiences.

Highlights

  • Breast milk is the normal species-specific food for human infants

  • The variables investigated included sociodemographic features, previous experiences, type of delivery, peripartum experiences, and factors affecting lactation

  • Even though the older age effect on breastfeeding initiation remains to be elucidated [14], it has to be taken into account that an increased maternal age at first childbirth has been recorded in most developed countries in the past 20 years [14], and, a high proportion of mothers aged 35 years or older may require specific attention

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Summary

Introduction

Breast milk is the normal species-specific food for human infants. Nutrients 2018, 10, 48 provides both short and long-term health benefits to mothers who breastfeed, and it has a positive impact on the society and the ecosystem [2,5,9]. For all of these reasons, the American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for six months after delivery, followed by continued breastfeeding while receiving appropriate and adequate complementary foods [2]. Despite the established benefits of breast milk, global breastfeeding rates remain far below international targets [10], in high-income countries [5], making the identification of modifiable risk factors a high priority [11]

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