Determinants of Exclusive Breastfeeding Cessation in the Early Postnatal Period among Culturally and Linguistically Diverse (CALD) Australian Mothers.

Felix Akpojene Ogbo,Jane Ussher,Olayide Ogunsiji,Sarah Khanlari,Bryanne Barnett Am,Kedir Y Ahmed,John Eastwood,Praween Senanayake,Sabrina Naz,Anne Mckenzie,Kingsley Agho,Andrew Page,Janette Perz,Osita Kingsley Ezeh

doi:10.3390/nu11071611

Abstract

There are limited epidemiological data on exclusive breastfeeding (EBF) among culturally and linguistically diverse (CALD) Australian mothers to advocate for targeted and/or culturally-appropriate interventions. This study investigated the determinants of EBF cessation in the early postnatal period among CALD Australian mothers in Sydney, Australia. The study used linked maternal and child health data from two local health districts in Australia (N = 25,407). Prevalence of maternal breastfeeding intention, skin-to-skin contact, EBF at birth, discharge, and the early postnatal period (1–4 weeks postnatal), were estimated. Multivariate logistic regression models were used to investigate determinants of EBF cessation in the early postnatal period. Most CALD Australian mothers had the intention to breastfeed (94.7%). Skin-to-skin contact (81.0%), EBF at delivery (91.0%), and at discharge (93.0%) were high. EBF remained high in the early postnatal period (91.4%). A lack of prenatal breastfeeding intention was the strongest determinant of EBF cessation (adjusted odds ratio [aOR] = 23.76, 95% CI: 18.63–30.30, for mothers with no prenatal breastfeeding intention and aOR = 6.15, 95% CI: 4.74–7.98, for those undecided). Other significant determinants of EBF cessation included a lack of partner support, antenatal and postnatal depression, intimate partner violence, low socioeconomic status, caesarean birth, and young maternal age (<20 years). Efforts to improve breastfeeding among women of CALD backgrounds in Australia should focus on women with vulnerabilities to maximise the benefits of EBF.

Highlights

Global health organisations recommend exclusive breastfeeding (EBF) for the first six months of life [1]
This study aimed to investigate the determinants of EBF cessation in the early postnatal period among culturally and linguistically diverse (CALD) Australian mothers in Sydney, New South Wales
EBF remained high in the early postnatal period among CALD Australian mothers (91.4%)

Summary

Introduction

Global health organisations (such as the World Health Organization and the United NationsChildren’s Fund, WHO/UNICEF) recommend exclusive breastfeeding (EBF) for the first six months of life [1]. EBF is defined as providing the infant human breastmilk only, and when needed, oral rehydration solution, or drops/syrups of vitamins, minerals, or medicines [2]. Appropriate EBF protects against childhood obesity [6] and has the potential to increase infant cognitive functioning [7]. EBF benefits the infant but is associated with improved maternal health (e.g., a reduced risk developing of type 2 diabetes mellitus) [8] and improved household productivity due to no cost of human milk [9]. Past research suggests that CALD subgroups are more likely to experience adverse health outcomes, including depressive symptoms [13] and poor uptake of cancer screening [14], compared to the non-CALD populations

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