Predicting Risk for Early Breastfeeding Cessation in Israel.

Abstract

This study aimed to 1) Examine factors associated with cessation of exclusive breastfeeding in Israel and 2) Develop predictive models to identify women at risk for early exclusive breastfeeding cessation. The study used data from longitudinal national representative infant nutrition survey in Israel (n = 2119 participants). Logistic regression was used to identify risk factors and build predictive models. The rate of exclusive breastfeeding cessation increased from 45.4% at 2months to 85.7% at 6months. Five factors were significantly associated with higher odds of exclusive breastfeeding cessation at 2months: being a primapara, low educational level, lack of previous breastfeeding experience, negative attitude towards birth, and lack of intention to breastfeed. Six factors were significantly associated with higher odds of exclusive breastfeeding cessation at 6months: younger age, being in a relationship with a partner, lower religiosity level, cesarean delivery, not taking folic acid during pregnancy, and negative attitude towards birth. Both 2 and 6-months models had good predictive performance (C-statistic of .72 and .68, accordingly). This nationwide study successfully identified several predictors of exclusive breastfeeding cessation and created breastfeeding cessation prediction tools for two time periods (2 and 6months). The resulting tools can be applied to identify women at risk for stopping exclusive breastfeeding in hospitals or at community clinics. Further studies should examine practical aspects of applying these tools in practice and explore whether applying those tools can lead to higher exclusive breastfeeding rates.