Používanie cumlíka a úspešnosť dojčenia
Výsledky väčšiny prác nasvedčujú tomu, že požívanie cumlíkov má za následok menej časté prikladanie dieťaťa k prsníku, tým aj slabšiu tvorbu mlieka a v konečnom dôsledku kratšie trvanie celkového a výlučného dojčenia. Používanie cumlíka sa preto neodporúča. Používanie cumlíka je takisto spojené s vyšším rizikom zápalu stredného ucha.
Pediatrics 1999 Oct;104(4):e50 |
Breastfeeding patterns in relation to thumb sucking and pacifier use.
Aarts C, Hornell A, Kylberg E, Hofvander Y, Gebre-Medhin M
Department of Women's and Children's Health, Section for International Maternal and Child Health, Uppsala University, Uppsala, Sweden. clara.aarts@ich.uu.se
OBJECTIVES: To analyze the influence of thumb sucking and pacifier use on breastfeeding patterns in exclusively breastfed infants, on the duration of exclusive breastfeeding, and on the total breastfeeding duration. STUDY DESIGN: Descriptive, longitudinal, prospective study. SETTING: The subjects were recruited from a population of 15 189 infants born in the maternity ward at the University Hospital, Uppsala, Sweden between May 1989 and December 1992. STUDY POPULATION: 506 mother-infant pairs. METHODS: Daily recordings by the mothers on infant feeding from the first week after delivery through the duration of the study. Fortnightly home visits with structured interviews by a research assistant. RESULTS: Pacifier use was associated with fewer feeds and shorter suckling duration per 24 hours, shorter duration of exclusive breastfeeding, and shorter total breastfeeding duration compared with no pacifier use. These associations were not found for thumb sucking. The possible negative effects of pacifiers on breastfeeding seemed to be related to the frequency of their use. Maternal age and education only slightly modified the association between pacifier use and breastfeeding duration. CONCLUSIONS: More frequent use of a pacifier was associated with shorter breastfeeding duration, even among a group of mothers who were highly motivated to breastfeed. breastfeeding duration, breastfeeding pattern, exclusive breastfeeding, pacifier use, thumb sucking.
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.
Acta Paediatr 1999 Feb;88(2):203-11 |
Breastfeeding patterns in exclusively breastfed infants: a longitudinal prospective study in Uppsala, Sweden.
Hornell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M
Department of Women's and Children's Health, Uppsala University, Sweden. ICH.sekretariat@ich.uu.se
Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to ut pressure on individual families to adopt preconceived patterns of infant feeding.
Hornell A, Aarts C, Kylberg E, Hofvander Y, Gebre-Medhin M
Department of Women's and Children's Health, Uppsala University, Sweden. ICH.sekretariat@ich.uu.se
Exclusive breastfeeding was studied among 506 infants in Uppsala, Sweden, based on daily recordings during the first 6 mo. The mothers had previously breastfed at least one infant for at least 4 mo. Most of the mothers considered that they breastfed on demand. Wide variations in breastfeeding frequency and suckling duration were found both between different infants and in the individual infant over time. At 2 wk, the mean frequency of daytime feeds (based on one 13-d record) between different infants ranged from 2.9 to 10.8 and night-time feeds from 1.0 to 5.1. The daytime suckling duration (based on one 24-h record) ranged from 20 min to 4h 35 min and night-time duration from 0 to 2h 8 min. At any given age, a maximum of only 2% of the infants were not breastfed during the night. At 4 mo, 95% of the infants were breastfeeding and 40% were exclusively breastfed at this age. Longer breastfeeding duration and longer duration of exclusive breastfeeding were both associated with higher frequency of breastfeeds, longer breastfeeding of the previous child and higher education. No gender differences were found. Maternal smoking was associated with shorter duration of exclusive breastfeeding, and pacifier use was associated with shorter duration of both exclusive breastfeeding and total breastfeeding. This study confirms that every mother-infant pair needs to be understood as a unique dyad throughout lactation. These data demonstrate a wide range of patterns among women who are exclusively breastfeeding and indicate that it would be inappropriate to ut pressure on individual families to adopt preconceived patterns of infant feeding.
Pediatrics 1999 Mar;103(3):E33 |
The effects of early pacifier use on breastfeeding duration.
Howard CR, Howard FM, Lanphear B, deBlieck EA, Eberly S, Lawrence RA
Department of Pediatrics, University of Rochester School of Medicine and Dentistry and the Children's Hospital Medical Center, Rochester, New York 14621, USA.
OBJECTIVE: To evaluate the effects of pacifier use and the timing of pacifier introduction on breastfeeding duration, problems, and frequency. METHODS: A cohort of 265 breastfeeding mother-infant dyads was followed prospectively. Maternal interviews were conducted at delivery, 2, 6, 12, and 24 weeks, and thereafter every 90 days until breastfeeding ended. Information was obtained regarding pacifier use, infant feeding, use of supplemental foods and breastfeeding frequency, duration, and problems. The effect of pacifier introduction by 6 weeks of age on breastfeeding duration was evaluated with Kaplan-Meier and Cox proportional hazards models. The effect of the timing of pacifier introduction (</=2 weeks and </=6 weeks) on breastfeeding duration at 2 and 3 months was evaluated using logistic regression modeling. RESULTS: A total of 181 mothers (68%) introduced a pacifier before 6 weeks. In adjusted analyses, pacifier introduction by 6 weeks was associated with a significantly increased risk for shortened duration of full (hazard ratio, 1.53; 95% confidence interval: 1.15, 2.05) and overall (hazard ratio, 1.61; 95% confidence interval: 1.19,2.19) breastfeeding. Women who introduced pacifiers tended to breastfeed their infants fewer times per day, with significant differences noted at 2 (8.1 +/- 2.6 vs 9.0 +/- 2.3) and 12 weeks' (6.3 +/- 2.0 vs 7.4 +/- 1.6) postpartum. At 12 weeks postpartum, women who introduced pacifiers also were more likely to report that breastfeeding was inconvenient and that they had insufficient milk supplies. Pacifier use begun either before 2 weeks or before 6 weeks' postpartum was not significantly associated with breastfeeding duration at 2 and 3 months. CONCLUSIONS: Pacifier use was independently associated with significant declines in the duration of full and overall breastfeeding. Breastfeeding duration in the first 3 months' postpartum, however, was unaffected by pacifier use. Women who introduced pacifiers tended to breastfeed their infants less frequently and experienced breastfeeding problems consistent with infrequent feeding. Findings from this study suggest that the decreases in breastfeeding duration associated with pacifier use may be a consequence of less frequent breastfeeding among women who introduce pacifiers to their infants.
Birth 1997 Jun;24(2):116-20 |
Breastfeeding and the use of pacifiers.
Righard L, Alade MO
Department of Pediatrics, University of Lund, University Hospital, Malmo, Sweden.
BACKGROUND: This study was designed to test the hypothesis that incorrect sucking technique and pacifier use are factors contributing to breastfeeding failure. METHOD: The nursing patterns of 82 exclusively breastfeeding mother-infant pairs were observed 4 to 5 days postpartum on the maternity ward at University Hospital in Malmo, Sweden. The breastfeeding outcome and pacifier use was assessed by regular telephone contacts during a 4-month follow-up. RESULTS: The breastfeeding rate at 4 months was 91 percent in the nonpacifier group and 44 percent in the pacifier group (p = 0.03). An incorrect superficial nipple-sucking technique at the breast from the start combined with pacifier use resulted in early weaning in most cases. CONCLUSION: To promote successful breastfeeding and to reduce nursing problems, an incorrect sucking technique should be prevented or corrected, and the use of pacifiers should be avoided or restricted.
Righard L, Alade MO
Department of Pediatrics, University of Lund, University Hospital, Malmo, Sweden.
BACKGROUND: This study was designed to test the hypothesis that incorrect sucking technique and pacifier use are factors contributing to breastfeeding failure. METHOD: The nursing patterns of 82 exclusively breastfeeding mother-infant pairs were observed 4 to 5 days postpartum on the maternity ward at University Hospital in Malmo, Sweden. The breastfeeding outcome and pacifier use was assessed by regular telephone contacts during a 4-month follow-up. RESULTS: The breastfeeding rate at 4 months was 91 percent in the nonpacifier group and 44 percent in the pacifier group (p = 0.03). An incorrect superficial nipple-sucking technique at the breast from the start combined with pacifier use resulted in early weaning in most cases. CONCLUSION: To promote successful breastfeeding and to reduce nursing problems, an incorrect sucking technique should be prevented or corrected, and the use of pacifiers should be avoided or restricted.
Pediatrics 1997 Mar;99(3):445-53 |
Pacifier use and short breastfeeding duration: cause, consequence, or coincidence?
Victora CG, Behague DP, Barros FC, Olinto MT, Weiderpass E
Departamento de Medicina Social, Universidade Federal de Pelotas, Brazil.
OBJECTIVES: Pacifiers are related to a shorter duration of breastfeeding. However, it is unclear whether this association is causal, because confounding, reverse causality, and self-selection of mothers may play a role. These issues were investigated through a combination of epidemiologic and ethnographic research in southern Brazil. METHODOLOGY: A population-based cohort of 650 mothers and infants were visited shortly after delivery and at 1, 3, and 6 months. The rate of complete follow-up was 96.8%. A subsample of 80 mothers and infants was selected for the ethnographic study, which included in-depth interviews and participant observations in the age range of 2 to 6 months with a mean of 4.5 visits. RESULTS: The epidemiologic study showed that pacifier use was common with 85% of users at 1 month. However, this was a dynamic process, with many infants starting or abandoning the pacifiers in any age range. Children who stopped breastfeeding in a given period were likely to take up the pacifier during that period. Further analyses excluded all infants not breastfed at 1 month of age and those who reportedly had breastfeeding problems, leaving 450 infants with full data. Intense pacifier users at 1 month (children who used the pacifiers during most of the day and at least until falling asleep) were four times more likely to stop breastfeeding by 6 months of age than nonusers. Users also had fewer daily breastfeedings than nonusers. After adjustment for several confounding variables, logistic regression showed that pacifier use was still associated with an odds ratio of 2.5 (95% confidence interval, 1.40 to 4.01) for stopping breastfeeding. The ethnographic analysis showed that pacifier use was widely regarded as a positive behavior and that mothers often strongly stimulated the infants to accept it. Although few mothers openly admitted that pacifiers might shorten breastfeeding, a considerable group effectively used pacifiers to get their infants off the breast or to increase the interval between feedings. The latter also had rigid breastfeeding styles that increased maternal-infant distance, had important concerns about objective aspects of infant growth and development, and were highly sensitive to infant crying. These behaviors were linked to intense comparison between themselves and other mothers and to a lack of self-confidence. Nonwhite mothers, those who delivered vaginally, and mothers of infant girls seemed to be more confident and less affected by these difficulties. The epidemiologic analysis confirmed that pacifier use was more closely associated with breastfeeding duration among nonwhite mothers and for normally delivered infants. CONCLUSIONS: Pacifiers may be an effective weaning mechanism used by mothers who have explicit or implicit difficulties in breastfeeding, but they are much less likely to affect infants whose mothers are confident about nursing. Breastfeeding promotion campaigns aimed specifically at reducing pacifier use will fail unless they also help women face the challenges of nursing and address their anxieties. The combination of epidemiologic and ethnographic methods was essential for understanding the complex relations between pacifier use and breastfeeding.
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.
Eur J Pediatr 1997 Nov;156(11):874-7 |
UNICEF/WHO baby-friendly hospital initiative: does the use of bottles and pacifiers in the neonatal nursery prevent successful breastfeeding? Neonatal Study Group.
Schubiger G, Schwarz U, Tonz O
Kinderspital, Luzern, Switzerland.
To promote breastfeeding, UNICEF/WHO have launched the "baby-friendly hospital initiative" focusing on hospital care routines during delivery and the first days of life. In industrialised countries, two aspects of the initiative have raised controversy: how do restriction of supplemental feedings and ban of bottles and pacifiers affect long-term breastfeeding performance? From ten centres 602 healthy newborns were randomly assigned either to a UNICEF group with restrictive fluid supplements and avoidance of bottles and pacifiers during the first 5 days of life, or to a standard group with conventional feeding practice. Breastfeeding was encouraged in both groups. The main study endpoints were the prevalences of breast-feeding on day 5, and after 2, 4 and 6 months. Of the newborns 46% violated the UNICEF protocol, mostly because of maternal requests to give a pacifier or supplements by bottle. In the standard group, the drop-out rate was 9.7%. No significant differences in breastfeeding frequency and duration could be found: (UNICEF vs standard) day 5: 100% vs 99%; 2 months: 88% vs 88%; 4 months: 75% vs 71%; 6 months: 57% vs 55%. Inclusion of drop-outs due to pacifier use did not alter the results. Conclusion: In our study population fluid supplements offered by bottle with or without the use of pacifiers during the first 5 days of life were not associated with a lower frequency or shorter duration of breastfeeding during the first 6 months of life.
Pediatr Dent 1999 Jul-Aug;21(4):255-60 |
Pacifier use and otitis media in infants twelve months of age or younger.
Jackson JM, Mourino AP
Advanced Education Program in Pediatric Dentistry, The Medical College of Virginia School of Dentistry, USA.
PURPOSE: The purpose of this study was two fold: to determine if within a selected population of infants the prevalence of otitis media was greater in pacifier users than in non-pacifier users, and to reveal if an association existed between otitis media and pacifier use. METHODS: The study consisted of 200 children, 12 months of age or younger. Parents were surveyed regarding children's pacifier habits, day care attendance, feeding habits, thumb sucking habits, exposure to parental smoking, and parental education level. RESULTS: The prevalence of otitis media in pacifier users (36%) was larger than that of non-pacifier users (23%), P < 0.05. A logistic regression analysis determined an association existed between otitis media and pacifier use, bottle feeding, thumb sucking, and day care utilization, P < or = 0.05. No association was discovered between otitis media and breast feeding, parental smoking and parental education level. CONCLUSION: The risk of developing otitis media in an infant is two times greater if a pacifier is used and five times greater if bottle fed or attending a day care facility.
Jackson JM, Mourino AP
Advanced Education Program in Pediatric Dentistry, The Medical College of Virginia School of Dentistry, USA.
PURPOSE: The purpose of this study was two fold: to determine if within a selected population of infants the prevalence of otitis media was greater in pacifier users than in non-pacifier users, and to reveal if an association existed between otitis media and pacifier use. METHODS: The study consisted of 200 children, 12 months of age or younger. Parents were surveyed regarding children's pacifier habits, day care attendance, feeding habits, thumb sucking habits, exposure to parental smoking, and parental education level. RESULTS: The prevalence of otitis media in pacifier users (36%) was larger than that of non-pacifier users (23%), P < 0.05. A logistic regression analysis determined an association existed between otitis media and pacifier use, bottle feeding, thumb sucking, and day care utilization, P < or = 0.05. No association was discovered between otitis media and breast feeding, parental smoking and parental education level. CONCLUSION: The risk of developing otitis media in an infant is two times greater if a pacifier is used and five times greater if bottle fed or attending a day care facility.
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.
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