Breastfeeding and Sociodemographic Determinants: Evidence from the "MAMI-MED" Cohort

Background/Objectives: Breastfeeding is key to maternal and child health, but adherence to WHO recommendations varies worldwide and is influenced by several maternal and paternal factors. In this study, we aim to describe the prevalence of breastfeeding practices and adherence to WHO guidelines among women, and to explore the maternal and paternal characteristics associated with these practices. Methods: Data were obtained from the "MAMI-MED" cohort, which included women enrolled during the first trimester of pregnancy at ARNAS Garibaldi Nesima in Catania (Italy). Breastfeeding practices and parental characteristics were assessed through interviews conducted at 12- and 24-month follow-ups. Results: The analyses involved 1312 women enrolled between December 2020 and October 2023. Mothers who breastfed, particularly those who exclusively breastfed for the first six months, showed a more favorable socioeconomic profile. Women with a medium (OR = 1.781; 95% CI: 1.258-2.521; p = 0.001) and high level of education (OR = 3.892; 95% CI: 2.255-6.718; p < 0.001), as well as those who had a spontaneous delivery (OR = 1.461; 95% CI: 1.090-1.958; p = 0.011), were more likely to breastfeed. Similarly, adherence to WHO recommendations was higher among women with a medium (OR = 2.144; 95% CI: 1.339-3.433; p = 0.002) and high education levels (OR = 2.611; 95% CI: 1.489-4.580; p < 0.001), non-smokers (OR = 2.256; 95% CI: 1.158-4.395; p = 0.017), and those with adequate gestational weight gain (OR = 1.506; 95% CI: 1.035-2.189; p = 0.032). Conclusions: Sociodemographic and behavioral factors, particularly maternal education, smoking status, mode of delivery, and gestational weight gain, significantly influence breastfeeding practices and adherence to WHO recommendations. These findings highlight the importance of targeted interventions to support breastfeeding, especially among women with less favorable socioeconomic profiles.