Vplyv vzdelania matky na úspešnosť dojčenia
Socio-epidemiologické výzkumy sa zhodujú v tom, že vzdelané ženy majú jednoznačne väčšiu snahu dojčiť a sú v dojčení úspešnejšie ako matky s nižším vzdelaním. Nezáujem o dojčenie a problémy s udržaním dostatočnej laktácie sa najčastejšie vyskytujú práve u veľmi mladých, slobodných a sociálne zle zabezpečených matiek. Naopak lepšie vzdelanie, vyššie spoločenské postavenie a dobré rodinné zázemie zvykne predikovať úspešné dojčenie. Dôležitý faktorom pri zahájení a udržaní dojčenia je aj podpora otca dieťaťa. Bola zistená štatisticky významná súvislosť medzi kladným postojom k dojčeniu a úrovňou vzdelania ako aj sociálnym postavením otca. Významná je takisto vzdelanostná úroveň a postoj matkinej matky. Úspešnosť dojčenia podstatne znižuje fajčenie mamičky, včasné zavádzanie príkrmov do stravy a používanie cumlíkov.
Acta Paediatr 1999 Apr;88(4):411-5 |
Factors associated with initiation and duration of breastfeeding in Italy.
Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M
Department of Pediatrics, San Paolo Hospital, Milan, Italy.
To evaluate factors associated with initiation and duration of breastfeeding in Italy, 1601 (73%) respondents among 2192 randomly selected mothers were interviewed within 1 mo of delivery. Mothers who started breastfeeding (85%) were followed-up for 12 mo. A compliance rate of 100% was obtained. At multiple logistic regression analysis, mother having been breastfed herself (p < 0.01), nursing guidance in the maternity ward (p = 0.01) and higher social class (p = 0.03) were positively associated with initiation of breastfeeding. We found that 42%, 19%, 10% and 4% mothers were still breastfeeding at 3, 6, 9 and 12 mo after delivery, respectively. Cox multiple regression analysis showed a negative association between duration of breastfeeding and pacifier use (p < 0.01), and apositive association with a higher level of maternal education (p = 0.04). Formula supplementation in the maternity ward (given to 30% of infants) was associated with a shorter duration of exclusive breastfeeding (p = 0.03). Mothers need support with breastfeeding, particularly those from lower social backgrounds and with lower levels of education. Early use of the pacifier should be discouraged.
Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M
Department of Pediatrics, San Paolo Hospital, Milan, Italy.
To evaluate factors associated with initiation and duration of breastfeeding in Italy, 1601 (73%) respondents among 2192 randomly selected mothers were interviewed within 1 mo of delivery. Mothers who started breastfeeding (85%) were followed-up for 12 mo. A compliance rate of 100% was obtained. At multiple logistic regression analysis, mother having been breastfed herself (p < 0.01), nursing guidance in the maternity ward (p = 0.01) and higher social class (p = 0.03) were positively associated with initiation of breastfeeding. We found that 42%, 19%, 10% and 4% mothers were still breastfeeding at 3, 6, 9 and 12 mo after delivery, respectively. Cox multiple regression analysis showed a negative association between duration of breastfeeding and pacifier use (p < 0.01), and apositive association with a higher level of maternal education (p = 0.04). Formula supplementation in the maternity ward (given to 30% of infants) was associated with a shorter duration of exclusive breastfeeding (p = 0.03). Mothers need support with breastfeeding, particularly those from lower social backgrounds and with lower levels of education. Early use of the pacifier should be discouraged.
J Perinat Med 1998;26(4):320-4 |
The incidence of breastfeeding in our environment.
Carbonell X, Botet F, Figueras J, Alvarez E, Riu A
Hospital Clinic-Maternitat, Institute of Gynecology, Obstetrics and Neonatology, Barcelona, Spain.
AIMS: To establish the incidence of breastfeeding and its persistence after three and six months; to identify the factors which might modify attitudes towards breastfeeding. METHODS: An interview, administered to mothers of term born infants of adequate weight for gestational age, after a delivery of one sole foetus, between 1st March and 31st May 1997. Mothers were asked about: previous pregnancies, children and type of feeding; during this pregnancy, their intentions regarding feeding; supervision of pregnancy, and the information received regarding breastfeeding; their work situation, and educational level. Questions regarding the neonatal period referred to the kind of lactation initiated, information received, and the use of a pacifier and supplements. A two-part poll was conducted by telephone after 3 months and after 6 months, enquiring about what kind of feeding was used, the reason for change (if any), who had provided information regarding the change, degree of satisfaction, and work situation. Three hundred and twenty-nine polls were completed, accounting for 70% of the births. RESULTS: During pregnancy, 91% of mothers had intended to breastfeed, and this figure was maintained at birth. A trend towards breastfeeding was observed: 74% of those who had fed earlier children artificially started breastfeeding this time, compared with 7% of mothers who changed from breastfeeding to artificial feeding. After three months, 57% of mothers continued to breastfeed their child, and 24% after six months. High educational level exerted a positive influence on the duration of breastfeeding (OR = 1.7; p = 0.03) and the giving of supplements had a negative effect (OR = 0.4; p = 0.04). The fact that mothers work outside the home did not modify the duration of breastfeeding. CONCLUSIONS: The rate of breastfeeding is high (91%). Among mothers with previous children, there is a greater trend to change from artificial feeding to breastfeeding (74% vs 7%; p < 0.002). The mother's educational level is the most important positive factor, and the early giving of supplements the most important negative factor.
Carbonell X, Botet F, Figueras J, Alvarez E, Riu A
Hospital Clinic-Maternitat, Institute of Gynecology, Obstetrics and Neonatology, Barcelona, Spain.
AIMS: To establish the incidence of breastfeeding and its persistence after three and six months; to identify the factors which might modify attitudes towards breastfeeding. METHODS: An interview, administered to mothers of term born infants of adequate weight for gestational age, after a delivery of one sole foetus, between 1st March and 31st May 1997. Mothers were asked about: previous pregnancies, children and type of feeding; during this pregnancy, their intentions regarding feeding; supervision of pregnancy, and the information received regarding breastfeeding; their work situation, and educational level. Questions regarding the neonatal period referred to the kind of lactation initiated, information received, and the use of a pacifier and supplements. A two-part poll was conducted by telephone after 3 months and after 6 months, enquiring about what kind of feeding was used, the reason for change (if any), who had provided information regarding the change, degree of satisfaction, and work situation. Three hundred and twenty-nine polls were completed, accounting for 70% of the births. RESULTS: During pregnancy, 91% of mothers had intended to breastfeed, and this figure was maintained at birth. A trend towards breastfeeding was observed: 74% of those who had fed earlier children artificially started breastfeeding this time, compared with 7% of mothers who changed from breastfeeding to artificial feeding. After three months, 57% of mothers continued to breastfeed their child, and 24% after six months. High educational level exerted a positive influence on the duration of breastfeeding (OR = 1.7; p = 0.03) and the giving of supplements had a negative effect (OR = 0.4; p = 0.04). The fact that mothers work outside the home did not modify the duration of breastfeeding. CONCLUSIONS: The rate of breastfeeding is high (91%). Among mothers with previous children, there is a greater trend to change from artificial feeding to breastfeeding (74% vs 7%; p < 0.002). The mother's educational level is the most important positive factor, and the early giving of supplements the most important negative factor.
Lancet 1996 Apr 20;347(9008):1072-5 |
Breastfeeding, dummy use, and adult intelligence.
Gale CR, Martyn CN
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
BACKGROUND: Several studies show that children who were breastfed as babies gain higher scores on intelligence tests than those who were bottlefed. Although these findings suggest that breastfeeding in early life may promote cognitive development, their interpretation is complicated by the current association between breastfeeding and higher social class. We investigated the relation between method of feeding in infancy and adult intelligence in a setting where breastfeeding was not linked with socioeconomic advantage. METHODS: We followed up 994 men and women, born between 1920 and 1930 in Hertfordshire, UK, for whom information on infant feeding had been recorded by health visitors. Intelligence was measured by the AH4 IQ test, taken on a computer. Factors significantly linked with IQ were investigated by multivariate analysis. FINDINGS: Study participants who had been exclusively breastfed gained slightly higher scores on the IQ test than those who had been exclusively bottlefed, or fed with both breast and bottle. IQ was lower in participants who had used a dummy (pacifier) in infancy, in those whose fathers were in manual occupations at the time of their birth, and in those whose mothers were young at the time they were born. Scores on the IQ test fell as the number of older siblings increased. In multivariate analysis, after adjustment for the effect of all other variables, no association was found between adult intelligence and method of feeding. Dummy use in infancy, number of older siblings, maternal age at birth of the participant, and father's occupational class remained independent predictors of adult intelligence. INTERPRETATION: The mechanisms that link type of feeding in early life with later intelligence may have more to do with the child's social environment that with the nutritional qualities of the milk.
Gale CR, Martyn CN
MRC Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
BACKGROUND: Several studies show that children who were breastfed as babies gain higher scores on intelligence tests than those who were bottlefed. Although these findings suggest that breastfeeding in early life may promote cognitive development, their interpretation is complicated by the current association between breastfeeding and higher social class. We investigated the relation between method of feeding in infancy and adult intelligence in a setting where breastfeeding was not linked with socioeconomic advantage. METHODS: We followed up 994 men and women, born between 1920 and 1930 in Hertfordshire, UK, for whom information on infant feeding had been recorded by health visitors. Intelligence was measured by the AH4 IQ test, taken on a computer. Factors significantly linked with IQ were investigated by multivariate analysis. FINDINGS: Study participants who had been exclusively breastfed gained slightly higher scores on the IQ test than those who had been exclusively bottlefed, or fed with both breast and bottle. IQ was lower in participants who had used a dummy (pacifier) in infancy, in those whose fathers were in manual occupations at the time of their birth, and in those whose mothers were young at the time they were born. Scores on the IQ test fell as the number of older siblings increased. In multivariate analysis, after adjustment for the effect of all other variables, no association was found between adult intelligence and method of feeding. Dummy use in infancy, number of older siblings, maternal age at birth of the participant, and father's occupational class remained independent predictors of adult intelligence. INTERPRETATION: The mechanisms that link type of feeding in early life with later intelligence may have more to do with the child's social environment that with the nutritional qualities of the milk.
East Mediterr Health J 1999 May;5(3):450-6 |
Maternal smoking and breastfeeding.
Najdawi F, Faouri M
Princess Haya Hospital, Royal Jordanian Medical Services, Amman, Jordan.
A 2-month study was undertaken to investigate the effects of maternal smoking on breastfeeding. A total of 500 mothers were interviewed twice postpartum and information about maternal smoking and sociodemographic factors was collected. After adjustment for maternal smoking and other confounders, results suggested that smoking had a direct effect on breastfeeding. The prevalence of breastfeeding reduced significantly among smokers but there was no significant reduction among non-smokers. Education and social class were related positively to continued breastfeeding but negatively to smoking. Because breastfeeding decreased with smoking, smoking should be discouraged, particularly in developing countries where breastfeeding constitutes an essential child survival measure.
Najdawi F, Faouri M
Princess Haya Hospital, Royal Jordanian Medical Services, Amman, Jordan.
A 2-month study was undertaken to investigate the effects of maternal smoking on breastfeeding. A total of 500 mothers were interviewed twice postpartum and information about maternal smoking and sociodemographic factors was collected. After adjustment for maternal smoking and other confounders, results suggested that smoking had a direct effect on breastfeeding. The prevalence of breastfeeding reduced significantly among smokers but there was no significant reduction among non-smokers. Education and social class were related positively to continued breastfeeding but negatively to smoking. Because breastfeeding decreased with smoking, smoking should be discouraged, particularly in developing countries where breastfeeding constitutes an essential child survival measure.
Soc Sci Med 2000 May;50(9):1189-96 |
The influence of maternal intergenerational education on health behaviors of women in peri-urban Bolivia.
Bende DE, McCann MF
Carolina Population Center, Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill 27599-7400, USA. deborah_bender@unc.edu
The influence of maternal education on infant mortality has been demonstrated repeatedly in health and social science literature. Less explored is the influence of the education level of the mother's mother. In the present paper the authors examine the possible effect of grandmother's education on maternal behaviors. The relationship between intergenerational education and selected health behaviors, including utilization of health services for prenatal care, breast-feeding and family planning, are reported. The data were collected in peri-urban Santa Cruz, Bolivia among mothers of infants between 0 and 18 months of age. It appears that grandmother's education does exert an effect on health behaviors above and beyond the effect of maternal education. This effect is more pronounced for health services which fall clearly in the domain of the formal health care system. While the results are exploratory, the results suggest the worth of further study and consideration of the influence of mothers' mothers in the design of culturally sensitive quality health services.
Bende DE, McCann MF
Carolina Population Center, Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill 27599-7400, USA. deborah_bender@unc.edu
The influence of maternal education on infant mortality has been demonstrated repeatedly in health and social science literature. Less explored is the influence of the education level of the mother's mother. In the present paper the authors examine the possible effect of grandmother's education on maternal behaviors. The relationship between intergenerational education and selected health behaviors, including utilization of health services for prenatal care, breast-feeding and family planning, are reported. The data were collected in peri-urban Santa Cruz, Bolivia among mothers of infants between 0 and 18 months of age. It appears that grandmother's education does exert an effect on health behaviors above and beyond the effect of maternal education. This effect is more pronounced for health services which fall clearly in the domain of the formal health care system. While the results are exploratory, the results suggest the worth of further study and consideration of the influence of mothers' mothers in the design of culturally sensitive quality health services.
Birth 1999 Sep;26(3):149-56 |
Does parental breastfeeding knowledge increase breastfeeding rates?
Susin LR, Giugliani ER, Kummer SC, Maciel M, Simon C, da Silveira LC
Department of Pathology, Fundacao Universidade do Rio Grande, Brazil.
OBJECTIVE: Although improving mothers' knowledge about breastfeeding can increase rates and duration of breastfeeding, little is known about the influence of fathers' knowledge. The purpose of this study was to assess the knowledge of mothers and fathers about breastfeeding before and after receiving postpartum advice and its relationship to the frequency of breastfeeding. METHODS: A clinical trial was performed with mothers and fathers of normal children born at the Hospital de Clinicas de Porto Alegre, Brazil, between July 1994 and March 1995. The study intervention consisted of postpartum advice supplied by means of a video film discussing basic topics of breastfeeding, an explanatory leaflet, and open discussion after viewing the video. The first 208 couples comprised the control group, the next 197 comprised experimental group 1, and the remaining 196 comprised experimental group 2. Immediately after delivery, mothers and fathers in the three groups answered a test on breastfeeding knowledge; they completed the same test at the end of the first month. All families received home visits at the end of the first, second, fourth, and sixth months, or until breastfeeding ceased. Logistic regression was used to evaluate the association between the mothers' and fathers' knowledge and frequency of breastfeeding. RESULTS: Postpartum advice increased the breastfeeding knowledge of mothers and fathers. The mothers with the highest level of knowledge had a 6.5 times higher chance of exclusively breastfeeding at the end of the third month, and 1.97 times higher chance of continuing breastfeeding to the end of the sixth month compared with other mothers. The fathers' knowledge also significantly influenced breastfeeding rates.The children whose fathers knew more had a 1.76 higher chance of being exclusively breastfed at the end of the first month, and 1.91 higher chance of receiving maternal milk at the end of the third month. CONCLUSION: A simple, inexpensive strategy can increase the level of breastfeeding knowledge of mothers and fathers and, consequently, have a positive impact on the frequency of breastfeeding.
Acta Paediatr 1999 Apr;88(4):416-21 |
Factors associated with the duration of breastfeeding amongst women in Perth, Australia.
Scott JA, Aitkin I, Binns CW, Aroni RA
School of Public Health, Curtin University of Technology, Perth, Australia. jscott@pfkedinburgh.ltd.uk
Duration of breastfeeding was studied in 556 women delivering at 2 maternity hospitals in Perth, Australia. At discharge 83.8% of women were breastfeeding their infants, including 6% who were giving complementary feeds. At 3 and 6 months, 61.8% and 49.9%, respectively, were still breastfeeding. In a Cox survival analysis of factors associated with duration of breastfeeding a positive association was found with maternal education, age and intended duration of breastfeeding.Male infants were more likely to be weaned before female infants and women whose partners were unemployed, or did not have a preference for breastfeeding, breastfed for shorter duration. There is still a need for programmes which support and encourage breastfeeding, focusing particularly on younger, less well-educated women who intend to breastfeed for less than the recommended 4-6 months.
Scott JA, Aitkin I, Binns CW, Aroni RA
School of Public Health, Curtin University of Technology, Perth, Australia. jscott@pfkedinburgh.ltd.uk
Duration of breastfeeding was studied in 556 women delivering at 2 maternity hospitals in Perth, Australia. At discharge 83.8% of women were breastfeeding their infants, including 6% who were giving complementary feeds. At 3 and 6 months, 61.8% and 49.9%, respectively, were still breastfeeding. In a Cox survival analysis of factors associated with duration of breastfeeding a positive association was found with maternal education, age and intended duration of breastfeeding.Male infants were more likely to be weaned before female infants and women whose partners were unemployed, or did not have a preference for breastfeeding, breastfed for shorter duration. There is still a need for programmes which support and encourage breastfeeding, focusing particularly on younger, less well-educated women who intend to breastfeed for less than the recommended 4-6 months.
Acta Paediatr 1999 Apr;88(4):411-5 |
Factors associated with initiation and duration of breastfeeding in Italy.
Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M
Department of Pediatrics, San Paolo Hospital, Milan, Italy.
To evaluate factors associated with initiation and duration of breastfeeding in Italy, 1601 (73%) respondents among 2192 randomly selected mothers were interviewed within 1 mo of delivery. Mothers who started breastfeeding (85%) were followed-up for 12 mo. A compliance rate of 100% was obtained. At multiple logistic regression analysis, mother having been breastfed herself (p < 0.01), nursing guidance in the maternity ward (p = 0.01) and higher social class (p = 0.03) were positively associated with initiation of breastfeeding. We found that 42%, 19%, 10% and 4% mothers were still breastfeeding at 3, 6, 9 and 12 mo after delivery, respectively. Cox multiple regression analysis showed a negative association between duration of breastfeeding and pacifier use (p < 0.01), and a positive association with a higher level of maternal education (p = 0.04). Formula supplementation in the maternity ward (given to 30% of infants) was associated with a shorter duration of exclusive breastfeeding (p = 0.03). Mothers need support with breastfeeding, particularly those from lower social backgrounds and with lower levels of education. Early use of the pacifier should be discouraged.
Riva E, Banderali G, Agostoni C, Silano M, Radaelli G, Giovannini M
Department of Pediatrics, San Paolo Hospital, Milan, Italy.
To evaluate factors associated with initiation and duration of breastfeeding in Italy, 1601 (73%) respondents among 2192 randomly selected mothers were interviewed within 1 mo of delivery. Mothers who started breastfeeding (85%) were followed-up for 12 mo. A compliance rate of 100% was obtained. At multiple logistic regression analysis, mother having been breastfed herself (p < 0.01), nursing guidance in the maternity ward (p = 0.01) and higher social class (p = 0.03) were positively associated with initiation of breastfeeding. We found that 42%, 19%, 10% and 4% mothers were still breastfeeding at 3, 6, 9 and 12 mo after delivery, respectively. Cox multiple regression analysis showed a negative association between duration of breastfeeding and pacifier use (p < 0.01), and a positive association with a higher level of maternal education (p = 0.04). Formula supplementation in the maternity ward (given to 30% of infants) was associated with a shorter duration of exclusive breastfeeding (p = 0.03). Mothers need support with breastfeeding, particularly those from lower social backgrounds and with lower levels of education. Early use of the pacifier should be discouraged.
Breastfeed Rev 1999 Mar;7(1):5-16 |
Factors associated with the initiation and duration of breastfeeding: a review of the literature.
Scott JA, Binns CW
Institute for Medical Research, PFK Edinburgh Ltd, Edinburgh, Scotland.
Breastfeeding is promoted internationally as the preferred method of feeding for infants up to the age of four to six months. As a consequence there is much research interest in factors which may be predictors of breastfeeding. This paper presents a review of the recent literature identifying factors associated with the initiation and duration of breastfeeding among Western women. Attention was focused on studies which employed multivariate analysis of the data and breastfeeding initiation and duration were considered as two uniquely separate events. This review reveals that the associations between breastfeeding and many of the factors commonly investigated were not consistent. Many of the strong associations previously reported in univariate studies were not evident in more recent studies which employed multivariate analysis to control for covariates and potential confounders. While there was a strong and consistent association with demographic factors such as maternal age and level of education, there was a less consistent association with factors such as marital and socioeconomic status. Similarly, the previously reported univariate associations between breastfeeding and biomedical factors such as parity, method of delivery and infant health were less consistent in multivariate studies. However, a consistent negative association has been reported between maternal smoking habits and breastfeeding duration. More recent studies have investigated the association between breastfeeding and psychosocial factors. There is evidence to suggest that fathers play an important role in the breastfeeding decision and that intended duration is a strong predictor of actual duration. Despite the inconsistency of the reported associations, this review highlights the fact that breastfeeding is multifactorial in nature and future programs aimed at promoting breastfeeding must take this into consideration.
Scott JA, Binns CW
Institute for Medical Research, PFK Edinburgh Ltd, Edinburgh, Scotland.
Breastfeeding is promoted internationally as the preferred method of feeding for infants up to the age of four to six months. As a consequence there is much research interest in factors which may be predictors of breastfeeding. This paper presents a review of the recent literature identifying factors associated with the initiation and duration of breastfeeding among Western women. Attention was focused on studies which employed multivariate analysis of the data and breastfeeding initiation and duration were considered as two uniquely separate events. This review reveals that the associations between breastfeeding and many of the factors commonly investigated were not consistent. Many of the strong associations previously reported in univariate studies were not evident in more recent studies which employed multivariate analysis to control for covariates and potential confounders. While there was a strong and consistent association with demographic factors such as maternal age and level of education, there was a less consistent association with factors such as marital and socioeconomic status. Similarly, the previously reported univariate associations between breastfeeding and biomedical factors such as parity, method of delivery and infant health were less consistent in multivariate studies. However, a consistent negative association has been reported between maternal smoking habits and breastfeeding duration. More recent studies have investigated the association between breastfeeding and psychosocial factors. There is evidence to suggest that fathers play an important role in the breastfeeding decision and that intended duration is a strong predictor of actual duration. Despite the inconsistency of the reported associations, this review highlights the fact that breastfeeding is multifactorial in nature and future programs aimed at promoting breastfeeding must take this into consideration.
Arch Pediatr 1998 May;5(5):489-96 |
Factors influencing the duration of breast feeding. A study of 150 women.
Branger B, Cebron M, Picherot G, de Cornulier M
Service d'epidemiologie et d'hygiene, CHU Pontchaillou, Rennes, France.
BACKGROUND: The duration of breast feeding has not yet been thoroughly described in France. A prospective survey has been performed on 150 breast feeding mothers to determine its duration. The objective of this study was to analyse predicting factors of this duration. METHODS: A questionnaire including sociological, psychological and medical variables was completed by the mothers and fathers. After discharge, the mothers were contacted every month by a physician until the completion of weaning. RESULTS: The median duration was 10 weeks. By univariate analysis, several variables were associated with a longer duration: decision to breast feed before pregnancy (12 weeks vs 9 weeks; P < 0.01), multiparity (17 weeks vs 12 weeks, P < 0.05), high paternal social level (14 weeks vs 9 weeks, P < 0.001), high maternal education level (12 weeks vs 9 weeks; P < 0.05), mother's idea of "bad" milk (9 weeks vs 30 weeks; P < 10(-6), satisfied mothers (11 weeks vs 2 weeks; P < 0.001), motivation to breast feed (P < 0.05), baby and mother in the same room during the night (13 weeks vs 10 weeks; P < 0.05), and formula supplementation (6 weeks vs 13 weeks; P < 0.01). The mother's return to work was related to a decline in the breast feeding rate at 12 weeks, yet working women generally breast fed the most frequently before returning to work, and many women breast fed and worked concomitantly. A Cox multivariate analysis took into account six significant variables: "bad" milk (lower duration), mother who had been fed, mother satisfied with breast feeding, multiparity, high maternal education, closer proximity of baby to mother (longer duration). DISCUSSION: The duration in our study is longer than in other studies in France. Predictive factors are sociological, linked to maternal education, and psychological, with antecedent of mother breast feeding and decision before pregnancy. The role of the mother's occupation was not very important because working women are generally at a higher social level. The role of the father was analysed, as well as the role of professional workers, family and breast feeding women's associations. CONCLUSION: Factors of breast feeding duration can be somewhat modified, but it is necessary to respect the plans of both the mother and the father. However, early assistance in the hospital and after discharge can help parents realize their plans for prolonged breast feeding and helps obviating the cessation of 20% of mothers during the 1st month.
Branger B, Cebron M, Picherot G, de Cornulier M
Service d'epidemiologie et d'hygiene, CHU Pontchaillou, Rennes, France.
BACKGROUND: The duration of breast feeding has not yet been thoroughly described in France. A prospective survey has been performed on 150 breast feeding mothers to determine its duration. The objective of this study was to analyse predicting factors of this duration. METHODS: A questionnaire including sociological, psychological and medical variables was completed by the mothers and fathers. After discharge, the mothers were contacted every month by a physician until the completion of weaning. RESULTS: The median duration was 10 weeks. By univariate analysis, several variables were associated with a longer duration: decision to breast feed before pregnancy (12 weeks vs 9 weeks; P < 0.01), multiparity (17 weeks vs 12 weeks, P < 0.05), high paternal social level (14 weeks vs 9 weeks, P < 0.001), high maternal education level (12 weeks vs 9 weeks; P < 0.05), mother's idea of "bad" milk (9 weeks vs 30 weeks; P < 10(-6), satisfied mothers (11 weeks vs 2 weeks; P < 0.001), motivation to breast feed (P < 0.05), baby and mother in the same room during the night (13 weeks vs 10 weeks; P < 0.05), and formula supplementation (6 weeks vs 13 weeks; P < 0.01). The mother's return to work was related to a decline in the breast feeding rate at 12 weeks, yet working women generally breast fed the most frequently before returning to work, and many women breast fed and worked concomitantly. A Cox multivariate analysis took into account six significant variables: "bad" milk (lower duration), mother who had been fed, mother satisfied with breast feeding, multiparity, high maternal education, closer proximity of baby to mother (longer duration). DISCUSSION: The duration in our study is longer than in other studies in France. Predictive factors are sociological, linked to maternal education, and psychological, with antecedent of mother breast feeding and decision before pregnancy. The role of the mother's occupation was not very important because working women are generally at a higher social level. The role of the father was analysed, as well as the role of professional workers, family and breast feeding women's associations. CONCLUSION: Factors of breast feeding duration can be somewhat modified, but it is necessary to respect the plans of both the mother and the father. However, early assistance in the hospital and after discharge can help parents realize their plans for prolonged breast feeding and helps obviating the cessation of 20% of mothers during the 1st month.
J R Soc Med 1997 Oct;90(10):551-9 |
Extreme attitudes to body shape, social and psychological factors and a reluctance to breast feed. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.
Barnes J, Stein A, Smith T, Pollock JI
Leopold Muller University Department of Child and Family Mental Health, Royal Free Hospital School of Medicine, London, UK.
Despite widespread advocacy of breast feeding, many babies are breast fed only briefly, if at all. Mothers' decisions on how to feed are often made before the birth; so we have sought demographic, social and psychological factors that might be amenable to intervention during pregnancy. In the Avon Longitudinal Study of Pregnancy and Childhood about 12,000 women completed questionnaires in pregnancy. Univariate analyses were carried out to establish which factors were related to breast feeding intentions. All significant factors in univariate analyses were entered into logistic regression analyses. Demographic characteristics independently related to intentions to breast feed included older maternal age, more maternal education, primiparity and not smoking; in previous work all these had been associated with actual feeding behaviour. Social relationship variables had a small influence. Of the psychological variables, a notable finding was that women who were preoccupied with their body shape and those who expressed controlling, less child-centred, responses to managing an infant in the postnatal months were less likely to express intentions to breast feed. Depression did not predict breast feeding intentions once the other factors had been taken into account. Health care professionals may be able to intervene to increase breast feeding by making routine enquiries during antenatal care and targeting appropriate subgroups.
Barnes J, Stein A, Smith T, Pollock JI
Leopold Muller University Department of Child and Family Mental Health, Royal Free Hospital School of Medicine, London, UK.
Despite widespread advocacy of breast feeding, many babies are breast fed only briefly, if at all. Mothers' decisions on how to feed are often made before the birth; so we have sought demographic, social and psychological factors that might be amenable to intervention during pregnancy. In the Avon Longitudinal Study of Pregnancy and Childhood about 12,000 women completed questionnaires in pregnancy. Univariate analyses were carried out to establish which factors were related to breast feeding intentions. All significant factors in univariate analyses were entered into logistic regression analyses. Demographic characteristics independently related to intentions to breast feed included older maternal age, more maternal education, primiparity and not smoking; in previous work all these had been associated with actual feeding behaviour. Social relationship variables had a small influence. Of the psychological variables, a notable finding was that women who were preoccupied with their body shape and those who expressed controlling, less child-centred, responses to managing an infant in the postnatal months were less likely to express intentions to breast feed. Depression did not predict breast feeding intentions once the other factors had been taken into account. Health care professionals may be able to intervene to increase breast feeding by making routine enquiries during antenatal care and targeting appropriate subgroups.
Ugeskr Laeger 1995 Apr 17;157(16):2311-5 |
Duration of breast feeding--which factors are significant?
Michaelsen KF, Larsen PS, Thomsen BL, Samuelson G
Forskningsinstitut for Human Ernaering og KVL Center for Fodevareforskning, Den Kgl. Veterinaer-og Landbohojskole, Frederiksberg.
Duration of breast-feeding (BF) was studied in 249 randomly chosen healthy, term infants of Danish origin of which 81% participated. BF was initiated by 99.5% of the mothers. At three, six, and nine months, 71%, 52%, and 33%, respectively, were still BF. Only one infant (0.5%) was exclusively BF beyond the age of seven months. In a Cox multiple regression analysis of factors influencing duration of BF, we found a positive association with maternal education (p < 0.001), and age (p = 0.02), and a negative association with the amount of formula given at the maternity ward (p < 0.001). Six months after delivery 79% of the mothers with higher school education (> or = 12 years) were still BF, compared to 29% with a low school education (< or = 9 years). There is still a need for an increased effort to support mothers in BF to be focused on younger mothers with short school education. Formula supplements during the first days of life, given to 73% of the infants, were associated with shorter duration of BF and should be discouraged.
Michaelsen KF, Larsen PS, Thomsen BL, Samuelson G
Forskningsinstitut for Human Ernaering og KVL Center for Fodevareforskning, Den Kgl. Veterinaer-og Landbohojskole, Frederiksberg.
Duration of breast-feeding (BF) was studied in 249 randomly chosen healthy, term infants of Danish origin of which 81% participated. BF was initiated by 99.5% of the mothers. At three, six, and nine months, 71%, 52%, and 33%, respectively, were still BF. Only one infant (0.5%) was exclusively BF beyond the age of seven months. In a Cox multiple regression analysis of factors influencing duration of BF, we found a positive association with maternal education (p < 0.001), and age (p = 0.02), and a negative association with the amount of formula given at the maternity ward (p < 0.001). Six months after delivery 79% of the mothers with higher school education (> or = 12 years) were still BF, compared to 29% with a low school education (< or = 9 years). There is still a need for an increased effort to support mothers in BF to be focused on younger mothers with short school education. Formula supplements during the first days of life, given to 73% of the infants, were associated with shorter duration of BF and should be discouraged.
J Public Health Med 1994 Sep;16(3):291-5 |
Determinants of breastfeeding in Salisbury and Durham.
Salt MJ, Law CM, Bull AR, Osmond C
MRC Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital.
BACKGROUND: The practice of breastfeeding is related to socio-demographic characteristics: both show marked variation by place within the United Kingdom. This study set out to test the commonly held assumption that geographical variations in breastfeeding practices are explained by socio-demographic differences. METHODS: The mothers of 326 six-week-old babies living in Salisbury or Durham Health Districts were interviewed to determine attitudes to breastfeeding practice. RESULTS: More mothers in Salisbury breastfed than mothers in Durham, both immediately after birth (Salisbury 79 per cent, Durham 54 per cent) and at six weeks (50 per cent and 26 per cent). Higher rates of breastfeeding after birth were associated with higher level of qualification, encouragement to breastfeed antenatally and the mother having been breastfed herself. Higher rates at six weeks were associated with higher level of qualification, higher parity and willingness to breastfeed away from home. The differences between districts persisted after adjustment for these variables, but were diminished when willingness to breastfeed away from home was taken into account. CONCLUSION: Differences between the two districts in breastfeeding practice cannot be wholly explained by traditional socio-demographic characteristics, and may be related to local culture. Health education is unlikely to change breastfeeding practices unless prevailing cultural attitudes also change.
Salt MJ, Law CM, Bull AR, Osmond C
MRC Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital.
BACKGROUND: The practice of breastfeeding is related to socio-demographic characteristics: both show marked variation by place within the United Kingdom. This study set out to test the commonly held assumption that geographical variations in breastfeeding practices are explained by socio-demographic differences. METHODS: The mothers of 326 six-week-old babies living in Salisbury or Durham Health Districts were interviewed to determine attitudes to breastfeeding practice. RESULTS: More mothers in Salisbury breastfed than mothers in Durham, both immediately after birth (Salisbury 79 per cent, Durham 54 per cent) and at six weeks (50 per cent and 26 per cent). Higher rates of breastfeeding after birth were associated with higher level of qualification, encouragement to breastfeed antenatally and the mother having been breastfed herself. Higher rates at six weeks were associated with higher level of qualification, higher parity and willingness to breastfeed away from home. The differences between districts persisted after adjustment for these variables, but were diminished when willingness to breastfeed away from home was taken into account. CONCLUSION: Differences between the two districts in breastfeeding practice cannot be wholly explained by traditional socio-demographic characteristics, and may be related to local culture. Health education is unlikely to change breastfeeding practices unless prevailing cultural attitudes also change.
J Epidemiol Community Health 1994 Jun;48(3):281-5 |
Breast feeding in Israel: maternal factors associated with choice and duration.
Ever-Hadani P, Seidman DS, Manor O, Harlap S
Department of Medical Ecoloy, Braun School of Public Health and Community Medicine, Hebrew University, Hadassah Medical School, Jerusalem, Israel.
STUDY OBJECTIVES--To determine the influence of maternal characteristics on the incidence and duration of breast feeding. DESIGN--All the women who delivered in three obstetric wards within a two year period were surveyed. These three wards cover 93% of all births in the Jerusalem district. Women were interviewed on breast feeding of the previous child on the first or second day post partum by a research nurse. PARTICIPANTS--Altogether 8486 women whose previous pregnancy had resulted in a live born singleton who survived for at least one year. MEASUREMENTS AND MAIN RESULTS--Breast feeding information was linked to demographic and health information from hospital records. Using logistic regression analysis, failure to start breast feeding was best predicted (p < 0.001) by caesarean delivery, infant's birth weight, maternal smoking habits, and mother being non-immigrant. Maternal age (< 24 or > 40 years) and father being an ultraorthodox Jew were also positively (p < 0.05) associated with the decision to breast feed. Long term breast feeding (three months or more) was strongly affected (p < 0.001) by maternal education level, with both women with the fewest and the greatest number of years of schooling more likely to breast feed. A similar association was observed in all ethnic groups. Primipara and grandmultipara (parity > 4), new immigrants, ultraorthodox Jews, and non-smokers breast fed their babies for longer. CONCLUSIONS--The importance of maternal characteristics in relation to breast feeding was shown. Caesarean delivery and the infant's birth weight were strongly related to the decision to breast feed as were the demographic characteristics of mother's age and her country of birth. Education was not related to this decision but was strongly associated with the duration of breast feeding, as was parity. The behavioural characteristics of smoking and being ultraorthodox were related to both the decision to start and the duration of breast feeding. Efforts to encourage breast feeding ought to be targeted during the hospital stay and post partum period towards women identified as being at increased risk.
Ever-Hadani P, Seidman DS, Manor O, Harlap S
Department of Medical Ecoloy, Braun School of Public Health and Community Medicine, Hebrew University, Hadassah Medical School, Jerusalem, Israel.
STUDY OBJECTIVES--To determine the influence of maternal characteristics on the incidence and duration of breast feeding. DESIGN--All the women who delivered in three obstetric wards within a two year period were surveyed. These three wards cover 93% of all births in the Jerusalem district. Women were interviewed on breast feeding of the previous child on the first or second day post partum by a research nurse. PARTICIPANTS--Altogether 8486 women whose previous pregnancy had resulted in a live born singleton who survived for at least one year. MEASUREMENTS AND MAIN RESULTS--Breast feeding information was linked to demographic and health information from hospital records. Using logistic regression analysis, failure to start breast feeding was best predicted (p < 0.001) by caesarean delivery, infant's birth weight, maternal smoking habits, and mother being non-immigrant. Maternal age (< 24 or > 40 years) and father being an ultraorthodox Jew were also positively (p < 0.05) associated with the decision to breast feed. Long term breast feeding (three months or more) was strongly affected (p < 0.001) by maternal education level, with both women with the fewest and the greatest number of years of schooling more likely to breast feed. A similar association was observed in all ethnic groups. Primipara and grandmultipara (parity > 4), new immigrants, ultraorthodox Jews, and non-smokers breast fed their babies for longer. CONCLUSIONS--The importance of maternal characteristics in relation to breast feeding was shown. Caesarean delivery and the infant's birth weight were strongly related to the decision to breast feed as were the demographic characteristics of mother's age and her country of birth. Education was not related to this decision but was strongly associated with the duration of breast feeding, as was parity. The behavioural characteristics of smoking and being ultraorthodox were related to both the decision to start and the duration of breast feeding. Efforts to encourage breast feeding ought to be targeted during the hospital stay and post partum period towards women identified as being at increased risk.
Acta Paediatr 1994 Jun;83(6):565-71 |
The Copenhagen cohort study on infant nutrition and growth: duration of breast feeding and influencing factors.
Michaelsen KF, Larsen PS, Thomsen BL, Samuelson G
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
Duration of breast feeding was studied in 249 randomly chosen, healthy, term infants of Danish origin of which 80.7% participated. Breast feeding was initiated by 99.5% of the mothers. At 3, 6 and 9 months, 71%, 52% and 33%, respectively, were still breast feeding. Only 1 infant (0.5%) was exclusively breast fed beyond 7 months of age. In a Cox multiple regression analysis of factors influencing duration of breast feeding, we found a positive association with maternal education (p < 0.001) and age (p = 0.02) and a negative association with the amount of formula given at the maternity ward (p < 0.001). Six months after delivery, 79% of the mothers with higher school education (> or = 12 years) were still breast feeding, compared to 29% with a low school education (< or = 9 years). There is still a need for an increased effort to support mothers in breast feeding, focusing particularly on younger mothers with short school education. Formula supplements during the first days of life, given to 73% of the infants, were associated with a shorter duration of breast feeding and should be discouraged.
Michaelsen KF, Larsen PS, Thomsen BL, Samuelson G
Research Department of Human Nutrition, Royal Veterinary and Agricultural University, Frederiksberg, Denmark.
Duration of breast feeding was studied in 249 randomly chosen, healthy, term infants of Danish origin of which 80.7% participated. Breast feeding was initiated by 99.5% of the mothers. At 3, 6 and 9 months, 71%, 52% and 33%, respectively, were still breast feeding. Only 1 infant (0.5%) was exclusively breast fed beyond 7 months of age. In a Cox multiple regression analysis of factors influencing duration of breast feeding, we found a positive association with maternal education (p < 0.001) and age (p = 0.02) and a negative association with the amount of formula given at the maternity ward (p < 0.001). Six months after delivery, 79% of the mothers with higher school education (> or = 12 years) were still breast feeding, compared to 29% with a low school education (< or = 9 years). There is still a need for an increased effort to support mothers in breast feeding, focusing particularly on younger mothers with short school education. Formula supplements during the first days of life, given to 73% of the infants, were associated with a shorter duration of breast feeding and should be discouraged.
Am J Perinatol 1993 Jul;10(4):300-3 |
Effect of expectant mothers' feeding plan on prediction of fathers' attitudes regarding breast-feeding.
Freed GL, Fraley JK
Robert Wood Johnson Clinical Scholars Program, University of North Carolina, Chapel Hill 27599-7590.
A mother's perception of the father's attitude toward breast-feeding may strongly influence her prenatal choice of infant feeding method; however, research has demonstrated that women do little better than chance in predicting these attitudes. this study sought to determine if differential perceptions of fathers' attitudes regarding breast-feeding existed between women who had made a prenatal decision to breast- or formula-feed their children. The 268 expectant mothers in prenatal classes completed a self-administered questionnaire. Chi-square analysis was performed to determine the significance of the association between maternal attitudes toward breast-feeding and intended feeding plan (breast or formula) and each predicted paternal attitudinal variable. The majority of subjects were white (80%) and married (95%). Seventy percent planned exclusive breast-feeding, and 68% felt the baby's father wanted them to breast-feed. Mothers who planned breast-feeding were more knowledgeable of its benefits, had more favorable perceptions, and were more likely to predict positive attitudes of fathers toward breast-feeding than those who planned formula feeding. Women who planned formula feeding predicted less positive paternal attitudes regarding breast-feeding; this perception (whether correct or incorrect) likely impacted on their choice of infant feeding method. More time should be devoted in prenatal classes and prenatal physician visits to breast-feeding education for mothers and fathers. Active encouragement of paternal participation in breast-feeding classes, usually directed toward women only, would foster understanding of the benefits of breast-feeding and the support fathers can provide.
Freed GL, Fraley JK
Robert Wood Johnson Clinical Scholars Program, University of North Carolina, Chapel Hill 27599-7590.
A mother's perception of the father's attitude toward breast-feeding may strongly influence her prenatal choice of infant feeding method; however, research has demonstrated that women do little better than chance in predicting these attitudes. this study sought to determine if differential perceptions of fathers' attitudes regarding breast-feeding existed between women who had made a prenatal decision to breast- or formula-feed their children. The 268 expectant mothers in prenatal classes completed a self-administered questionnaire. Chi-square analysis was performed to determine the significance of the association between maternal attitudes toward breast-feeding and intended feeding plan (breast or formula) and each predicted paternal attitudinal variable. The majority of subjects were white (80%) and married (95%). Seventy percent planned exclusive breast-feeding, and 68% felt the baby's father wanted them to breast-feed. Mothers who planned breast-feeding were more knowledgeable of its benefits, had more favorable perceptions, and were more likely to predict positive attitudes of fathers toward breast-feeding than those who planned formula feeding. Women who planned formula feeding predicted less positive paternal attitudes regarding breast-feeding; this perception (whether correct or incorrect) likely impacted on their choice of infant feeding method. More time should be devoted in prenatal classes and prenatal physician visits to breast-feeding education for mothers and fathers. Active encouragement of paternal participation in breast-feeding classes, usually directed toward women only, would foster understanding of the benefits of breast-feeding and the support fathers can provide.
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