factors associated with breastfeeding rates at birth and discontinuation before one month, france,...
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FACTORS ASSOCIATED WITH BREASTFEEDING RATES AT BIRTH AND DISCONTINUATION BEFORE ONE MONTH, FRANCE,
2012Benoit SALANAVE, Catherine De LAUNAY, Caroline GUERRISI, Katia CASTETBON.
Nutritional Surveillance and Epidemiology Unit (USEN), French Institute for Public Health Surveillance,University Paris 13, Bobigny, France Contact: [email protected]
Poster Reference Number: PO0150
Background and Objectives: France is one of the European countries where breastfeeding rates
are among the lowest. Using data of the national survey Epifane on feeding practices during the first year of life, our objectives were to describe breastfeeding rates at birth and one month, and to identify factors associated with breastfeeding initiation and with early cessation before one month.
Methods: Epifane was carried out using a 2-stage stratified random sample of infants born between the 16 th of
January and the 5th of April 2012 in 136 maternity wards in mainland France. Detailed information on breastfeeding and formula use was collected during the maternity stay using a self-completed questionnaire, and at one month by phone interview. Factors associated with breastfeeding initiation and discontinuation were identified using logistic regressions.
Results: At maternity, the participation rate was 81% and 3,374 infants were included.
Conclusions: Targeted programs should be implemented to support prolonged breastfeeding in young
mothers and those from low educational level. Actions should also be particularly focused on the sharp fall of breastfeeding rates after home return, which is sizeable as early as at the first week after birth.
Keywords: Breastfeeding, cohort, newborns
Among mothers who have initiated breastfeeding at birth and with available data at one month (n=1681), 20% have stopped nursing their baby before the end of the 4th week. Factors associated with breastfeeding discontinuation were the same as those mentioned for initiation (Table), along with exclusive/mixed breastfeeding and various complaints such as mastitis.
Table: MOTHERS’ CHARACTERISTICS ASSOCIATED WITH BREASTFEEDING INITIATION Ajusted OR*
Maternal age Ref: 25-29 years old18-24 years old30-34 years old35 years and over
0.971.441.29
Country of birth Ref: France Elsewhere 4.23
Smoking status during pregnancy Ref: Smoking No smoking 1.38
Attending delivery preparation courses Ref: No course One course or more 1.60
Mothers who have been breastfed themselves Ref: No Yes 2.16
Breastfeeding of older siblings Ref: Primiparous Multiparous having breastfed at least one childMultiparous without previous breastfeeding experience
2.550.15
Image of the breastfeeding woman Ref: Bad GoodRather good
8.463.35
Moment to choice milk feeding practice Ref: No decision Before pregnancyDuring pregnancy
2.011.62
Information on infant feeding Ref: No information at allMother informed by the official leaflet on breastfeedingMother informed but not through the official leafletMother informed during previous pregnancy
4.64 1.58 1.50
Promotion information from Ref: Non active maternitythe maternity unit (score)
Very active maternityActive maternity
0.750.95
* Multiple logistic regression adjusted on marital status, education, BMI before pregnancy, delivery mode, early skin-to-skin contact, congenital malformation, child disease, maternity score on staff information to promote breastfeeding. Bold OR: P<0,05.
60%
31%
9%
46%
35%
19%
Figure: MILK FEEDING FROM MATERNITY STAY TO 4 WEEKS
Breastfeeding rates at birth varied according to maternal characteristics (Table). Moreover, a positive perception of breastfeeding and information on infant feeding were positively associated with breastfeeding initiation.
More than two third of newborns (69 %) were breastfed in maternity unit (60 % exclusively, 9 % partially). At one month, half of them (54 %) were still breastfed but only 35 % exclusively (Figure).