Early predictors of short duration of exclusive breastfeeding among Havana women

Abstract

ProblemIn Cuba, only 40.9% of infants under the age of six months are exclusively breastfed with the average duration of exclusivity being only 2.4 months. Evidence to guide the development of breastfeeding interventions among Cuban women to achieve exclusive breastfeeding to six months is limited. The objective was to identify early predictors for discontinuation of exclusive breastfeeding before six months among Cuban women. MethodsIn a cohort study, 273 maternal-infant pairs were recruited immediately following childbirth at a public hospital in Havana, Cuba and followed up to six months postpartum. A univariate and multivariate strategy was used to identify early predictors of the discontinuation of exclusive breastfeeding before six months. ResultsWhile all women were exclusively breastfeeding at hospital discharge, only 20.5% continued to six months postpartum. The average duration of exclusive breastfeeding was 3.13 months (SD ± 2.14 months). Factors associated with the early discontinuation of exclusive breastfeeding were: (1) breastfeeding not initiated within the first hour of birth, (2) infant birthweight <3.3 kgs, (3) pacifier use, (4) maternal dissatisfaction with infant growth, (5) maternal mental health problems at one month and (6) low breastfeeding self-efficacy at birth and one month. In the multivariate analysis, only maternal dissatisfaction with infant growth progress at one month and birth weight <3.3 kg predicted the early discontinuation of exclusive breastfeeding. ConclusionWomen who gave birth to an infant with a lower birth weight and were dissatisfied with their infant's growth trajectory were high risk to prematurely discontinue exclusive breastfeeding before six months.