Factors Associated with Breastfeeding Initiation and Continuation: A Meta-Analysis

Area of Science:

• Public Health
• Maternal and Child Health
• Evidence Synthesis

Background:

• Breastfeeding initiation and continuation are crucial for infant and maternal health.
• Identifying key factors influencing breastfeeding is essential for developing effective support strategies.
• Existing literature on maternal and infant characteristics associated with breastfeeding requires quantitative evaluation.

Purpose of the Study:

• To quantitatively evaluate the literature on maternal and infant characteristics influencing breastfeeding.
• To assess the quantity, quality, and consistency of studies on breastfeeding.
• To conduct a meta-analysis to determine summary relative risks (RRs) for key factors affecting breastfeeding.

Main Methods:

• Systematic review of observational studies in developed nations (PubMed, CINAHL through March 2016).
• Inclusion of studies reporting risk measures for 6 high-impact factors: smoking, mode of delivery, parity, dyad separation, maternal education, and maternal breastfeeding education.
• Data abstraction by one author, reviewed by a second independent author, with data evaluated and interpreted by all co-authors.
• Meta-analysis using standard techniques and random-effects models to calculate summary RRs.

Main Results:

• Six high-impact factors were analyzed across numerous studies (e.g., maternal education [62 papers], mode of delivery [47 papers]).
• Significant factors for breastfeeding initiation included high maternal education (RR 2.28), dyad connection (RR 2.01), and maternal nonsmoking (RR 1.76).
• Similar results were observed for breastfeeding continuation, indicating consistent associations across different outcomes.

Conclusions:

• Despite methodological heterogeneity, consistent associations were found for perinatally identifiable factors.
• Maternal education, dyad bonding, and nonsmoking status are strong predictors of breastfeeding success.
• Findings can guide the development of targeted interventions to enhance breastfeeding education and support for families.