Details:

Alternative Title:
BMC Public Health
Personal Author:
England, Lucinda ; Brenner, Ruth ; Bhaskar, Brinda ; Simons-Morton, Bruce ; Das, Abhik ; ... More +
England, Lucinda ; Brenner, Ruth ; Bhaskar, Brinda ; Simons-Morton, Bruce ; Das, Abhik ; Revenis, Mary ; Mehta, Nitin ; Clemens, John Less -
Description:
Background

Little is known about the role of breastfeeding contraindications in breastfeeding practices. Our objectives were to 1) identify predictors of breastfeeding initiation and duration among a cohort of predominately low-income, inner-city women, and 2) evaluate the contribution of breastfeeding contraindications to breastfeeding practices.

Methods

Mother-infant dyads were systematically selected from 3 District of Columbia hospitals between 1995 and 1996. Breastfeeding contraindications and potential predictors of breastfeeding practices were identified through medical record reviews and interviews conducted after delivery (baseline). Interviews were conducted at 3–7 months postpartum and again at 7–12 months postpartum to determine breastfeeding initiation rates and duration. Multivariable logistic regression analysis was used to identify baseline factors associated with initiation of breastfeeding. Cox proportional hazards models were generated to identify baseline factors associated with duration of breastfeeding.

Results

Of 393 study participants, 201 (51%) initiated breastfeeding. A total of 61 women (16%) had at lease one documented contraindication to breastfeeding; 94% of these had a history of HIV infection and/or cocaine use. Of the 332 women with no documented contraindications, 58% initiated breastfeeding, vs. 13% of women with a contraindication. In adjusted analysis, factors most strongly associated with breastfeeding initiation were presence of a contraindication (adjusted odds ratio [AOR], 0.19; 95% confidence interval [CI], 0.08–0.47), and mother foreign-born (AOR, 4.90; 95% CI, 2.38–10.10). Twenty-five percent of study participants who did not initiate breastfeeding cited concern about passing dangerous things to their infants through breast milk. Factors associated with discontinuation of breastfeeding (all protective) included mother foreign-born (hazard ratio [HR], 0.55; 95% CI 0.39–0.77) increasing maternal age (HR for 5-year increments, 0.80; 95% CI, 0.69–0.92), and infant birth weight ≥ 2500 grams (HR, 0.45; 95% CI, 0.26–0.80).

Conclusions

Breastfeeding initiation rates and duration were suboptimal in this inner-city population. Many women who did not breastfeed had contraindications and/or were concerned about passing dangerous things to their infants through breast milk. It is important to consider the prevalence of contraindications to breastfeeding when evaluating breastfeeding practices in high-risk communities.


Subjects:
[+]
Adult Attitude To Health Birth Weight Breast Feeding Cohort Studies District Of Columbia Female HIV Infections Humans Infant Infant, Newborn Maternal Age Maternal Behavior Mothers Poverty Proportional Hazards Models Substance-Related Disorders Urban Population Weaning
Source:
BMC Public Health. 2003; 3:28.
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:bca88e27224f0fc1b139afbbafa260a89c1bdc7f1edddec6129ffff078badbc2
Download URL:
https://stacks.cdc.gov/view/cdc/3444/cdc_3444_DS1.pdf
File Type:

Supporting Files

• 	1471-2458-3-28.nxml	txt
  	license.txt	txt

More +