Advertisement

Maternal and Child Health Journal

, Volume 16, Issue 8, pp 1665–1671 | Cite as

Breastfeeding Practices Among First-Time Mothers and Across Multiple Pregnancies

  • Tori Sutherland
  • Christopher B. Pierce
  • Joan L. Blomquist
  • Victoria L. Handa
Article

Abstract

To investigate maternal characteristics associated with breastfeeding initiation and success. Women enrolled in the Mothers Outcomes After Delivery study reported breastfeeding practices 5–10 years after a first delivery. Women were classified as successful breastfeeding initiators, unsuccessful initiators, or non-initiators. For the first birth, demographic and obstetrical characteristics were compared across these three breastfeeding groups. For multiparous women, agreement in breastfeeding status between births was evaluated. Multivariate regression analysis was used to identify characteristics associated with non-initiation and unsuccessful breastfeeding across all births. Of 812 participants, 740 (91%) mothers tried to breastfeed their first child and 593 (73%) reported breastfeeding successfully. In a multivariate analysis, less educated women were less likely to initiate breastfeeding (odds ratio (OR) for non-initiation 1.97; 95% confidence interval (CI) 1.23, 3.14). There was a notable decrease in breastfeeding initiation with increasing birth order: compared to the first birth, the odds for non-initiation after a second delivery almost doubled (OR 1.83, 95% CI 1.42, 2.35) and the odds for non-initiation after a third delivery were further increased (OR 2.44, 95% CI 1.56, 3.82). Successful breastfeeding in a first pregnancy was a predictor of subsequent breastfeeding initiation and success. Specifically, women who did not attempt breastfeeding or who reported unsuccessful attempts to breastfeed at first birth were unlikely to initiate breastfeeding at later births. Cesarean delivery was not associated with breastfeeding initiation (OR 1.01; 95% CI 0.68, 1.48) or success (OR 1.33; 95% CI 0.92, 1.94). Breastfeeding practices after a first birth are a significant predictor of breastfeeding in subsequent births.

Keywords

Breastfeeding initiation Cesarean delivery Multiparity Maternal education Healthy People 2020 

Abbreviations

MOAD Study

Mothers’ Outcomes After Delivery Study

NHANES III

Third national health and nutrition examination survey

Notes

Acknowledgments

The MOAD study was supported by NIH grant RO1HD056275.

Conflict of interest

The authors have no conflicts to declare.

References

  1. 1.
    Gartner, L. M., Morton, J., Lawrence, R. A., Naylor, A. J., O’Hare, D., Schanler, R. J., et al. (1995). Breastfeeding and the use of human milk. Pediatrics, 115(2), 496–506.Google Scholar
  2. 2.
    Chen, A., & Rogan, W. J. (2004). Breastfeeding and the risk of postneonatal death in the United States. Pediatrics, 113(5), e435–e439.PubMedCrossRefGoogle Scholar
  3. 3.
    Kramer, M. S., & Kakuma, R. (2002). Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews, 1, CD003517.Google Scholar
  4. 4.
    American College of Obstetricians and Gynecologists. (2007). Breastfeeding: Maternal and infant aspects. ACOG Committee Opinion No. 361. Obstetrics and Gynecology, 109, 479–480.CrossRefGoogle Scholar
  5. 5.
    World Health Organization. (2002). The optimal duration of exclusive breastfeeding: Report of an expert consultation. Geneva: WHO Department of Nutrition for Health and Development.Google Scholar
  6. 6.
    Bartick, M., & Reinhold, A. (2010). The burden of suboptimal breastfeeding in the United States: A pediatric cost analysis. Pediatrics, 125(5), e1048–e1056.PubMedCrossRefGoogle Scholar
  7. 7.
    US Department of Health and Human Services. (2010). Healthy people 2020 program: MICH-21: Increase the proportion of infants who are breastfed. http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicid=26. Accessed 21 December, 2010.
  8. 8.
    Li, R., Ogden, C., Ballew, C., Gillespie, C., & Grummer-Strawn, L. (2002). Prevalence of exclusive breastfeeding among US infants: The third national health and nutrition examination survey (Phase II, 1991–1994). American Journal of Public Health, 92(7), 1107–1110.PubMedCrossRefGoogle Scholar
  9. 9.
    Dewey, K. G., Nommsen-Rivers, L. A., Heinig, M. J., & Cohen, R. J. (2003). Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics, 112(3;1), 607–619.PubMedCrossRefGoogle Scholar
  10. 10.
    Forste, R., & Hoffmann, J. P. (2008). Are US mothers meeting the healthy people 2010 breastfeeding targets for initiation, duration, and exclusivity? The 2003 and 2004 National Immunization Surveys. Journal of Human Lactation, 24(3), 278–288.PubMedCrossRefGoogle Scholar
  11. 11.
    McDowell, M. M., Wang, C. Y., & Kennedy-Stephenson, J. (2008). Breastfeeding in the United States: Findings from the national health and nutrition examination surveys, 1999–2006. Hyattsville, MD: National Center for Health Statistics.Google Scholar
  12. 12.
    Giovannini, M., Riva, E., Banderali, G., Salvioni, M., Radaelli, G., & Agostoni, C. (2005). Exclusive versus predominant breastfeeding in Italian maternity wards and feeding practices through the first year of life. Journal of Human Lactation, 21(3), 259–265.PubMedCrossRefGoogle Scholar
  13. 13.
    Theofilogiannakou, M., Skouroliakou, M., Gounaris, A., Panagiotakos, D., & Markantonis, S. L. (2006). Breast-feeding in Athens, Greece: Factors associated with its initiation and duration. Journal of Pediatric Gastroenterology and Nutrition, 43(3), 379–384.PubMedCrossRefGoogle Scholar
  14. 14.
    Wiklund, I., Edman, G., & Andolf, E. (2007). Cesarean section on maternal request: reasons for the request, self-estimated health, expectations, experience of birth and signs of depression among first-time mothers. Acta Obstetricia et Gynecologica Scandnavica, 86(4), 451–456.CrossRefGoogle Scholar
  15. 15.
    Zanardo, V., Svegliado, G., Cavallin, F., Giustardi, A., Cosmi, E., Litta, P., et al. (2010). Elective cesarean delivery: Does it have a negative effect on breastfeeding? Birth, 37, 275–279.PubMedCrossRefGoogle Scholar
  16. 16.
    Kruse, L., Denk, C. E., Feldman-Winter, L., & Rotondo, F. M. (2006). Longitudinal patterns of breastfeeding initiation. Maternal and Child Health Journal, 10, 13–18.PubMedCrossRefGoogle Scholar
  17. 17.
    Maryland Health Care Commission. (2010). Maryland hospital performance evaluation guide. http://mhcc.maryland.gov/consumerinfo/hospitalguide/hospital_guide/reports/find_a_condition/condition_detail_b.asp?condition_cd=Moms&care_cd=D01OB. Accessed 21 December, 2010.
  18. 18.
    Centers for Disease Control and Prevention. (2010). National immunization survey methods: Wording of the breastfeeding questions. http://www.cdc.gov/breastfeeding/data/NIS_data/survey_methods.htm. Accessed 21 December, 2010.
  19. 19.
    Szldo, M., & Nieto, F. J. (2000). Epidemiology: Beyond the basics. Gaithersburg: Aspen Publishers.Google Scholar
  20. 20.
    Diggle, P., Heagerty, P., Liang, K. Y., & Zeger, S. (2002). Analysis of longitudinal data (2nd ed.). New York: New Oxford University Press.Google Scholar
  21. 21.
    Heck, K. E., Schoendorf, K. C., Chavez, G. F., & Braveman, P. (2003). Does postpartum length of stay affect breastfeeding duration? A population-based study. Birth, 30, 153–159.PubMedCrossRefGoogle Scholar
  22. 22.
    Margolis, L. H., & Schwartz, J. B. (2000). The relationship between the timing of maternal postpartum hospital discharge and breastfeeding. Journal of Human Lactation, 16(2), 121–128.PubMedCrossRefGoogle Scholar
  23. 23.
    Menacker, F., & Hamilton, B. E. (2010). Recent trends in cesarean delivery in the United States. Hyattsville: National Center for Health Statistics.Google Scholar
  24. 24.
    Gillespie, B., D’Arcy, H., Schwartz, K., Bobo, J. K., & Foxman, B. (2006). Recall of age of weaning and other breastfeeding variables. International Breastfeeding Journal, 1(4), 1–10.Google Scholar
  25. 25.
    Dyson, L., McCormick, F., & Renfrew, M. J. (2005). Interventions for promoting the initiation of breastfeeding. Cochrane Database of Systematic Reviews, (2), CD001688.Google Scholar
  26. 26.
    Centers for Disease Control and Prevention. (2011). The CDC guide to breastfeeding interventions: Maternity care practices. http://www.cdc.gov/breastfeeding/pdf/BF_guide_1.pdf. Accessed on 25 May 2011.
  27. 27.
    Britton, C., McCormick, F. M., Renfrew, M. J., Wade, A., & King, S. E. (2007). Support for breastfeeding mothers. Cochrane Database of Systematic Reviews, (1), CD001141.Google Scholar
  28. 28.
    DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2008). Effect of maternity-care practices on breastfeeding. Pediatrics, 122(Suppl 2), S43–S49.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Tori Sutherland
    • 1
  • Christopher B. Pierce
    • 2
  • Joan L. Blomquist
    • 3
  • Victoria L. Handa
    • 4
  1. 1.University of Texas Southwestern Medical CenterDallasUSA
  2. 2.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Department of GynecologyGreater Baltimore Medical CenterBaltimoreUSA
  4. 4.Department of Gynecology and ObstetricsJohns Hopkins School of MedicineBaltimoreUSA

Personalised recommendations