Maternal Breastfeeding Technique and Early Breastfeeding Problems as Predictors of Exclusive Breastfeeding Duration...

Globally, exclusive breastfeeding (EBF) rates remain < 50%, with the highest rate of discontinuation occurring within the first 30 days. Early identification of breastfeeding difficulties is essential for timely intervention and extension of the EBF duration.

To determine the association between early assessment of breastfeeding techniques (within 48 hr postpartum), breastfeeding-related breast complications (e.g., mastitis, fissures, engorgement, and pain), and EBF duration during the first month.

This prospective observational study included 120 mother-infant dyads who were followed up for 30 days postpartum. The breastfeeding technique was assessed during rooming-in using the United Nations Children's Fund (UNICEF) Breastfeeding Observation Aid, and breast-related problems were recorded. The EBF duration was tracked through weekly telephone follow-up. Kaplan-Meier survival curves and Cox regression models were used to analyze the associations between breastfeeding technique, breast complications, and EBF duration.

At 30 days of age, 43% of the infants were exclusively breastfed. Each additional breastfeeding difficulty was associated with a 17% higher risk of EBF interruption over time (adjusted HR: 1.17; 95% CI [1.08, 1.30]; p < 0.001). Breast-related problems during the first week postpartum, present in 29.2% of dyads, were also linked to early EBF cessation (adjusted HR, 1.77; 95% CI [1.07, 2.92]; p = 0.020).

Difficulties in breastfeeding techniques and breast-related problems were significantly associated with a shorter EBF duration in the first month. Structured tools such as the Breastfeeding Observation Aid may support the early identification of at-risk dyads and improve EBF outcomes during the neonatal period.