Abstract
BackgroundHealth authorities recommend 6 months of fully breastfeeding and continuation of breastfeeding for at least a year. Many women initiate breastfeeding in hospital but discontinue before the six-month period, and therefore do not optimise the public health benefits. The aim of this study was to determine whether these women could be identified at hospital discharge, to enable targeted interventions.MethodsA secondary analysis of women who intended to breastfeed and were enrolled in a large randomised trial was undertaken. Women were enrolled in the antenatal period and antenatal, delivery and six month postnatal questionnaires were completed. Univariate and multivariate analyses were undertaken to determine the variables associated with early cessation of breastfeeding within six months, compared to women who continued to breastfeed.ResultsOf 2148 women who initiated breastfeeding in hospital, 877 continued to breastfed either partially (N = 262) or fully (N = 615) until six months postpartum and 1271 ceased breastfeeding early. Median breastfeeding duration in women who ceased early was 3+6 weeks (IQR 1+1 to 11+2 weeks). In multivariate analysis, factors that were significantly associated with early cessation of breastfeeding were maternal factors of lower education (less than 12 years of schooling, no completion of further education), smoking (pre-pregnancy or during pregnancy), and newborn factors of preterm birth and low birthweight (all p < 0.01). These variables correctly identify 83% of women.ConclusionWe can identify women who initiate and then prematurely discontinue breastfeeding prior to hospital discharge. Evaluation of additional interventions to support longer duration of breastfeeding in women at risk of ceasing prematurely is needed.
Highlights
Health authorities recommend 6 months of fully breastfeeding and continuation of breastfeeding for at least a year
Of the 2399 women enrolled in the original study, 2148 (89.5%) women initiated breastfeeding in hospital
The key findings of the study were that the maternal demographic factors of education and smoking status, and the newborn variables of prematurity and birth weight exerted an independent effect upon breastfeeding duration
Summary
Health authorities recommend 6 months of fully breastfeeding and continuation of breastfeeding for at least a year. Many women initiate breastfeeding in hospital but discontinue before the six-month period, and do not optimise the public health benefits. The World Health Organization and National Health and Medical Research Council Australia (NHMRC) recommend fully breastfeeding infants until 6 months, with continuation of breastfeeding to 12 months of age [1,2]. Whilst the majority of Australian babies are breastfed when discharged from hospital (92.3%), by six months rates of breastfeeding have dropped to 50.2% [3]. Long-term benefits to the breastfed child include a reduction in both type 1 and type 2 diabetes mellitus, obesity and reduced rates of lymphoma and leukaemia in adult life [1,6]
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