Predictors of suboptimal breastfeeding: an opportunity for public health interventions

Eur J Public Health. 2016 Apr;26(2):282-9. doi: 10.1093/eurpub/ckv203. Epub 2015 Nov 4.

Abstract

Background: Sub-optimum breastfeeding significantly contributes to the global burden of disease. Our aim was to identify risk factors associated with suboptimal breastfeeding in Southern Croatia.

Methods: Between February 2008 and August 2009, 773 mother-infant pairs were recruited from University Hospital of Split Maternity Unit. Mothers were interviewed at birth, 3, 6, 12 and 24 months.

Results: Ninety-nine percent of mothers initiated breastfeeding but only 2.2% of them exclusively breastfed whilst in hospital. At 24 months, 4.1% of mothers were breastfeeding. Exclusive and any breastfeeding at 3 months was negatively associated with maternal education of 12 years or less, smoking during pregnancy, intention to use a pacifier and in-hospital formula supplementation. In addition, exclusive breastfeeding at 3 months was negatively associated with primiparity, antenatal course non-attendance and not receiving assistance with breastfeeding from hospital staff. Antenatal course non-attendance and discussing infant feeding with a health professional during pregnancy lowered the odds for any breastfeeding at 6 months. At 12 and 24 months, a lower level of education, antenatal course non-attendance and not receiving advice in hospital on feeding frequency was significantly associated with lower odds of breastfeeding. Additionally, intention to use a pacifier was found to be a negative predictor of breastfeeding at 12 months.

Conclusions: Important modifiable risk factors found to be significantly associated with suboptimal breastfeeding include smoking during pregnancy, intention to use a pacifier, in-hospital formula supplementation, not receiving advice from hospital staff on normal feeding patterns, not receiving assistance with breastfeeding in hospital and antenatal course non-attendance.

MeSH terms

  • Breast Feeding / psychology*
  • Breast Feeding / statistics & numerical data*
  • Croatia
  • Hospitals, University
  • Humans
  • Infant Formula / statistics & numerical data
  • Intention
  • Mothers / education
  • Mothers / psychology*
  • Prenatal Care / statistics & numerical data
  • Public Health
  • Risk Factors
  • Smoking / epidemiology
  • Socioeconomic Factors
  • Time Factors