Background: Despite high levels of breastfeeding initiation in Australia, only 47 percent of women
are breastfeeding (exclusively or partially) six months later, with marked differences between social
groups. It is important to identify women who are at increased risk of early cessation of
breastfeeding.
Methods: Data from the three arms of a randomised controlled trial were pooled and analysed as
a cohort using logistic regression to identify which factors predicted women continuing to feed any
breast milk at six months postpartum. The original trial included 981 primiparous women attending
a public, tertiary, women's hospital in Melbourne, Australia in 1999–2001. The trial evaluated the
effect of two mid-pregnancy educational interventions on breastfeeding initiation and duration. In
the 889 women with six month outcomes available, neither intervention increased breastfeeding
initiation nor duration compared to standard care. Independent variables were included in the
predictive model based on the literature and discussion with peers and were each tested
individually against the dependent variable (any breastfeeding at six months).
Results: Thirty-three independent variables of interest were identified, of which 25 qualified for
inclusion in the preliminary regression model; 764 observations had complete data available.
Factors remaining in the final model that were positively associated with breastfeeding any breast
milk at six months were: a very strong desire to breastfeed; having been breastfed oneself as a baby;
being born in an Asian country; and older maternal age. There was an increasing association with
increasing age. Factors negatively associated with feeding any breast milk at six months were: a
woman having no intention to breastfeed six months or more; smoking 20 or more cigarettes per
day pre-pregnancy; not attending childbirth education; maternal obesity; having self-reported
depression in the six months after birth; and the baby receiving infant formula while in hospital.
Conclusion: In addition to the factors commonly reported as being associated with breastfeeding
in previous work, this study found a negative association between breastfeeding outcomes and
giving babies infant formula in hospital, a high maternal body mass index, and self-reported maternal
depression or anxiety in the six months after the baby was born. Interventions that seek to increase
breastfeeding should consider focusing on women who wish to breastfeed but are at high risk of
early discontinuation.
Background: Despite high levels of breastfeeding initiation in Australia, only 47 percent of women
are breastfeeding (exclusively or partially) six months later, with marked differences between social
groups. It is important to identify women who are at increased risk of early cessation of
breastfeeding.
Methods: Data from the three arms of a randomised controlled trial were pooled and analysed as
a cohort using logistic regression to identify which factors predicted women continuing to feed any
breast milk at six months postpartum. The original trial included 981 primiparous women attending
a public, tertiary, women's hospital in Melbourne, Australia in 1999–2001. The trial evaluated the
effect of two mid-pregnancy educational interventions on breastfeeding initiation and duration. In
the 889 women with six month outcomes available, neither intervention increased breastfeeding
initiation nor duration compared to standard care. Independent variables were included in the
predictive model based on the literature and discussion with peers and were each tested
individually against the dependent variable (any breastfeeding at six months).
Results: Thirty-three independent variables of interest were identified, of which 25 qualified for
inclusion in the preliminary regression model; 764 observations had complete data available.
Factors remaining in the final model that were positively associated with breastfeeding any breast
milk at six months were: a very strong desire to breastfeed; having been breastfed oneself as a baby;
being born in an Asian country; and older maternal age. There was an increasing association with
increasing age. Factors negatively associated with feeding any breast milk at six months were: a
woman having no intention to breastfeed six months or more; smoking 20 or more cigarettes per
day pre-pregnancy; not attending childbirth education; maternal obesity; having self-reported
depression in the six months after birth; and the baby receiving infant formula while in hospital.
Conclusion: In addition to the factors commonly reported as being associated with breastfeeding
in previous work, this study found a negative association between breastfeeding outcomes and
giving babies infant formula in hospital, a high maternal body mass index, and self-reported maternal
depression or anxiety in the six months after the baby was born. Interventions that seek to increase
breastfeeding should consider focusing on women who wish to breastfeed but are at high risk of
early discontinuation.
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