Breastfeeding during the first year of life: estimates using records generated in general pediatrics
Riccardo Pertile1, Lucia Bombarda2, Mariangela Pedron2
1Department of Clinical and Evaluative Epidemiology, Trento Health Service, Trento, Italy - riccardo.pertile@apss.tn.it.
Insights
Exclusive breastfeeding rates drop significantly by six months, with maternal citizenship, education, and childbirth preparation influencing maintenance. These findings highlight areas for public health interventions to support breastfeeding mothers.
Area of Science:
- Public Health
- Pediatrics
- Maternal and Child Health
Background:
- Monitoring breastfeeding in the first year is crucial for infant health.
- Exclusive breastfeeding for at least six months is a key community indicator.
- Understanding factors affecting breastfeeding duration is essential for targeted support.
Purpose of the Study:
- To assess exclusive breastfeeding trends in infants born in Trentino (2009-2013).
- To evaluate the decline in exclusive breastfeeding rates by six months.
- To identify socio-demographic and clinical factors associated with breastfeeding maintenance up to six months.
Main Methods:
- Utilized data from the Italian Certificate of Delivery Assistance (CedAP) and Pediatric Health Booklets (96.7% linkage).
- Analyzed trends in exclusive breastfeeding and monthly decreases.
- Examined associations between breastfeeding duration and maternal citizenship, residence, education, employment, parity, birth type, passive smoke exposure, and childbirth preparation course attendance.
Main Results:
- Exclusive breastfeeding at birth was 83.5%, decreasing to 34.7% by six months.
- Maternal citizenship, area of residence, and education level significantly influenced exclusive breastfeeding at six months.
- Parity, passive smoke exposure, and childbirth preparation course attendance showed significant associations with breastfeeding maintenance.
Conclusions:
- The Pediatric Health Booklet combined with CedAP data provides a robust system for monitoring breastfeeding.
- Breastfeeding rates decline notably between birth and six months.
- Identified factors suggest opportunities for public health interventions to enhance breastfeeding support and duration.
Background:
The monitoring of breastfeeding during a child's first year of life is highly recommended. The proportion of children who are exclusively breastfed for at least six months is a strong indicator of breastfeeding promotion in the community. The objectives of the study were to survey the exclusive breastfeeding of children during the first year of life for cohorts born in Trentino (north-eastern Italy) in 2009 to 20013, to evaluate the decrease of exclusive breastfeeding at 6 months and to analyze possible relationships between the maintenance of breastfeeding up to the age of 6 months and certain maternal socio-demographic characteristics, as well as clinical aspects of the pregnancy and birth.
Methods:
Cohorts born in Trentino between 2009 and 2013 were studied, calculating the proportion of infants who were breastfed upon discharge from the hospital (source: data on the CedAP informative flow, that is the Italian Certificate of Delivery Assistance data-base). The data provided on the 12-Month Health Evaluation Form found in the Pediatric Health Booklet, completed by regional family pediatricians, was linked with that of the respective CedAP (96.7% linkage). The trend for exclusive breastfeeding and its monthly decrease was analyzed. The maintenance of exclusive breastfeeding until the age of 6 months was analyzed in relation to citizenship, area of residence, maternal education level and employment status, parity, single or multiple birth, infant exposure to passive smoke and attendance or non-attendance of a state-promoted childbirth preparation course. This final variable was studied solely for primiparous women, who are generally most likely to attend a childbirth preparation course. All results were adjusted for the following potential confounding variables: "birth type," "prematurity" and "feeding method upon discharge from the hospital."
Results:
CedAP data revealed that 83.5% of live infants were exclusively breastfed and that this percentage decreased to 34.7% by the age of 6 months (35.4% among full-term infants and 27% among premature infants). Data from the Province of Trento demonstrates that exclusive breastfeeding up to the age of 6 months is influenced by the mother's citizenship, area of residence and education level, but not by her employment status. In addition, the study revealed a significant association with parity, passive smoke exposure and attendance of a childbirth preparation course.
Conclusions:
The Pediatric Health Booklet with its information on the state of health of children (in combination with data from the CedAP) offers a valid tool for monitoring breastfeeding during the first year of life. Data confirmed a decrease in the rate of breastfeeding between birth and the first month of life and between the first and sixth months of living at home. The results regarding the conditions that favour and discourage breastfeeding suggest potential public health care measures to improve children's health.
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