Breastfeeding practices during the first month postpartum and associated factors: impact on breastfeeding survival
Forough Mortazavi1, Seyed Abbas Mousavi2, Reza Chaman3
1Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, IR Iran.
Insights
Predominant breastfeeding is common in Iran, with partial breastfeeding increasing discontinuation risk. Interventions are needed to promote exclusive breastfeeding and educate mothers on formula
Area of Science:
- Maternal and Child Health
- Pediatrics
- Public Health Nutrition
Background:
- Introduction of fluids to infants postpartum is a prevalent practice in Iran.
- This practice may pose risks to infant health.
- Limited data exists on the prevalence and impact of these practices on breastfeeding duration.
Purpose of the Study:
- To determine the prevalence of breastfeeding practices in the first month postpartum.
- To identify factors associated with the introduction of fluids in early infancy.
- To assess the impact of fluid supplementation on breastfeeding survival.
Main Methods:
- Longitudinal study in Shahroud, Iran (May 2011-October 2013).
- 358 mothers enrolled during the third trimester.
- Monthly follow-up to breastfeeding cessation using Kaplan-Meier and Cox regression analyses.
Main Results:
- Predominant breastfeeding prevalence was 58.2%, partial breastfeeding 8.6%.
- Partial breastfeeding significantly increased the risk of breastfeeding discontinuation (HR=2.23, P=0.001).
- Maternal age, higher family income, and breastfeeding difficulties were associated with partial breastfeeding.
Conclusions:
- Predominant breastfeeding is highly prevalent in the study area.
- Interventions promoting exclusive breastfeeding and adherence to WHO guidelines are recommended.
- Early postpartum education on formula's impact on breastfeeding continuation is crucial.
Background:
The introduction of fluids to infants during the first days postpartum, which may be harmful to infant health, is a common practice in Iran.
Objectives:
This study aimed to find the prevalence of breastfeeding practices using monthly dietary recall and factors associated with introduction of fluids during the first month of life and determine the effects of these supplementations on breastfeeding survival.
Patients And Methods:
This longitudinal study carried out in Shahroud, Iran from May 2011 to October 2013. Using convenient sampling strategy, 358 mothers in their third trimester of pregnancy were enrolled in the study and completed the questionnaires. Then the data regarding the introduction of fluids during first month postpartum was collected. We followed women monthly up to breastfeeding cessation. Kaplan-Meier and time-to-event methods were used to assess breastfeeding survival. A multinomial logistic regression analysis was used to identify the variables that determined breastfeeding practices at the first month postpartum. The Cox regression analysis was used to estimate the effect of variables on breastfeeding survival.
Results:
The prevalence of exclusive, predominant, and partial breastfeeding during the first month postpartum were 33.1%, 58.2%, and 8.6%, respectively. Predominant breastfeeding was associated with the lack of breastfeeding experience (OR = 1.93; 95% CI [1.02 - 3.66]). Partial breastfeeding was associated with the maternal age ≥ 30 y (OR = 5.96; CI [1.66 - 21.37]), family income higher than the mean (OR = 3.39; 95% CI [1.17 - 9.81]), and breastfeeding difficulties score higher than mean (OR = 3.09; 95% CI [1.10 - 8.71]). The Cox regression analysis revealed that breastfeeding practices at the first month was associated with an increased risk for breastfeeding discontinuation. The hazard ratio of breastfeeding discontinuation for predominant and partial breastfeeding groups were 1.11 (95% CI: 0.82, 1.51; P = 0.49) and 2.23 (95% CI: 1.39, 3.58; P = 0.001), respectively compared to the exclusive group.
Conclusions:
The prevalence of predominant breastfeeding during the first month postpartum is high in Shahroud. Interventions to strengthen adherence to WHO guidelines for breastfeeding should be considered. Breastfeeding education providers at the hospitals should emphasize the effects of formula on breastfeeding continuation at early postpartum.
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