Skip to main content
Log in

Factors associated with breastfeeding duration: a prospective cohort study in Sichuan Province, China

  • Original article
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Background

The World Health Organization (WHO) recommends exclusive breastfeeding for 6 months and continued breastfeeding thereafter with appropriate complementary foods for at least 2 years or longer. This study aimed to determine the factors associated with breastfeeding duration in Sichuan Province of China.

Methods

A prospective longitudinal study of 695 women, with a follow-up response rate of 71.9%, was conducted in Jiangyou, Sichuan Province in the period of 2010–2011. Participants were interviewed at discharge and followed up by telephone at 1, 3, 6 and 12 months postpartum. Breastfeeding duration was estimated by the Kaplan-Meier method. Cox regression analyses were performed to identify factors associated with the breastfeeding duration.

Results

The median duration of “any breastfeeding” was 8.0 [95% confidence interval (CI): 7.8, 8.2] months. Maternal age less than 25 years [adjusted hazard ratio (HR): 1.61; 95% CI: 1.32, 1.96] and maternal return to work before 6 months postpartum (adjusted HR: 1.69; 95% CI: 1.32, 2.17) were associated with a shorter duration of breastfeeding. Women who delivered at hospital (adjusted HR: 1.33; 95% CI: 1.05, 1.67), introduced solid foods (adjusted HR: 1.30; 95% CI: 1.02, 1.64) and intended to stop breastfeeding within 6 months, or undecided how long to breastfeed (adjusted HR: 1.41; 95% CI: 1.16, 1.72), were more likely to terminate lactation within 1 year.

Conclusions

The duration of breastfeeding in Jiangyou was far below the recommendation of the WHO. Education programs targeting vulnerable subgroups of mothers should be provided in Sichuan to help them maintain breastfeeding as long as possible.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. American Academy of Pediatrics, Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2012;129:827–841.

    Article  Google Scholar 

  2. Fallahzadeh H, Golestan M, Rezvanian T, Ghasemian Z. Breastfeeding history and overweight in 11 to 13-year-old children in Iran. World J Pediatr 2009;5:36–41.

    Article  PubMed  Google Scholar 

  3. Su D, Pasalich M, Lee AH, Binns CW. Ovarian cancer risk is reduced by prolonged lactation: a case-control study in southern China. Am J Clin Nutr 2013;97:354–359.

    Article  CAS  PubMed  Google Scholar 

  4. Baker JL, Gamborg M, Heitmann BL, Lissner L, Sorensen TIA, Rasmussen KM. Breastfeeding reduces postpartum weight retention. Am J Clin Nutr 2008;88:1543–1551.

    Article  CAS  PubMed  Google Scholar 

  5. World Health Organization, United Nations Children’s Fund. Global strategy for infant and young child feeding. Geneva: World Health Organization, 2003.

    Google Scholar 

  6. Qiu L, Yun Z, Binns CW, Lee A, Xie X. A cohort study of infant feeding practices in city, suburban and rural areas in Zhejiang Province, PR China. Int Breastfeed J 2008;3: 6.

    Article  Google Scholar 

  7. Xu F, Binns C, Yu P, Bai Y. Determinants of breastfeeding initiation in Xinjiang, PR China, 2003–2004. Acta Paediatr 2007;96:257–260.

    Article  PubMed  Google Scholar 

  8. Liu P, Qiao L, Xu F, Zhang M, Wang Y, Binns CW. Factors associated with breastfeeding duration: a 30-month cohort study in northwest china. J Hum Lact 2013;29:253–259.

    Article  CAS  PubMed  Google Scholar 

  9. Qiu L, Binns CW, Zhao Y, Lee AH, Xie X. Breastfeeding practice in Zhejiang province, PR China, in the context of melamine-contaminated formula milk. J Health Popul Nutr 2010;28:189–198.

    PubMed Central  PubMed  Google Scholar 

  10. Xu F, Qiu L, Binns CW, Liu X. Breastfeeding in China: a review. Int Breastfeed J 2009;4: 6.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Tang L, Pan X, Lee AH, Binns CW. Progress and challenges in maternal health care in China. In: Berhardt LV, ed. Advances in Medicine and Biology. New York: Nova Science Publishers, 2013: 137–149.

    Google Scholar 

  12. Yan L, Liu Z, Sun L, Chen J. Feeding methods and complementary feeding practices of infants and children under 2 years old in rural areas of Sichuan Province. Mod Prevent Med 2009;36:629–631, 642. [In Chinese]

    Google Scholar 

  13. Tarrant M, Fong DYT, Wu KM, Lee ILY, Wong EMY, Sham A, et al. Breastfeeding and weaning practices among Hong Kong mothers: a prospective study. BMC Pregnancy Childbirth 2010;10: 27.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Chuang CH, Chang PJ, Chen YC, Hsieh WS, Hurng BS, Lin SJ, et al. Maternal return to work and breastfeeding: a populationbased cohort study. Int J Nurs Stud 2010;47:461–474.

    Article  PubMed  Google Scholar 

  15. Chang JH, Chan WT. Analysis of factors associated with initiation and duration of breast-feeding: a study in Taitung Taiwan. Acta Paediatr Taiwan 2003;44:29–34.

    PubMed  Google Scholar 

  16. Xu F, Binns C, Zheng S, Wang Y, Zhao Y, Lee A. Determinants of exclusive breastfeeding duration in Xinjiang, PR China. Asia Pac J Clin Nutr 2007;16:316–321.

    PubMed  Google Scholar 

  17. Grjibovski AM, Yngve A, Bygren LO, Sjostrom M. Sociodemographic determinants of initiation and duration of breastfeeding in northwest Russia. Acta Paediatr 2005;94:588–594.

    Article  PubMed  Google Scholar 

  18. Scott JA, Landers MC, Hughes RM, Binns CW. Factors associated with breastfeeding at discharge and duration of breastfeeding. J Paediatr Child Health 2001;37:254–261.

    Article  CAS  PubMed  Google Scholar 

  19. Liu JA, Wang Q, Lu ZX. Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China. BMC Health Serv Res 2010;10: 115.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Tang L, Binns CW, Luo C, Zhong Z, Lee AH. Determinants of breastfeeding at discharge in rural China. Asia Pac J Clin Nutr 2013;22:443–448.

    PubMed  Google Scholar 

  21. Xu F, Binns C, Wu J, Yihan R, Zhao Y, Lee A. Infant feeding practices in Xinjiang Uygur Autonomous Region, People’s Republic of China. Public Health Nutr 2007;10:198–202.

    Article  PubMed  Google Scholar 

  22. World Health Organization. Indicators for assessing infant and young child feeding practices–part I: definition. Geneva: World Helath Organization, 2008.

    Google Scholar 

  23. Tang L, Binns CW, Lee AH, Pan X, Chen S, Yu C. Low prevalence of breastfeeding initiation within the first hour of life in a rural area of Sichuan Province, China. Birth 2013;40:134–142.

    Article  PubMed  Google Scholar 

  24. Ma L, Chi L, Su Y, Qian X, Chen W, Ye Y. Feeding practices of infants and children aged 0–18 months in Guangdong. Chin J Child Health Care 2007;15:588–590. [In Chinese]

    Google Scholar 

  25. Centers for Disease Control and Prevention. Racial and ethnic differences in breastfeeding initiation and duration, by state-National Immunization Survey, United States, 2004–2008. MMWR Morb Mortal Wkly Rep 2010;59:327–334.

    Google Scholar 

  26. Scott JA, Binns CW, Oddy WH, Graham KI. Predictors of breastfeeding duration: evidence from a cohort study. Pediatrics 2006;117:646–655.

    Article  Google Scholar 

  27. Schwarz EB, Ray RM, Stuebe AM, Allison MA, Ness RB, Freiberg MS, et al. Duration of lactation and risk factors for maternal cardiovascular disease. Obstet Gynecol 2009;113:974–982.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Forster DA, McLachlan HL, Lumley J. Factors associated with breastfeeding at six months postpartum in a group of Australian women. Int Breastfeed J 2006;1: 18.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Chaves RG, Lamounier JA, Cesar CC. Factors associated with duration of breastfeeding. J Pediatr (Rio J) 2007;83:241–246.

    Google Scholar 

  30. World Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Geneva: World Health Organization, 2009.

    Google Scholar 

  31. Scott JA, Binns CW, Graham KI, Oddy WH. Predictors of the early introduction of solid foods in infants: results of a cohort study. BMC Pediatr 2009;9: 60.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Vingraite J, Bartkeviciute R, Michaelsen KF. A cohort study of term infants from Vilnius, Lithuania: feeding patterns. Acta Paediatr 2004;93:1349–1355.

    Article  CAS  PubMed  Google Scholar 

  33. Xu F, Binns C, Lee A, Wang Y, Xu B. Introduction of complementary foods to infants within the first six months postpartum in Xinjiang, PR China. Asia Pac J Clin Nutr 2007;16:462–466.

    PubMed  Google Scholar 

  34. Jiang W, Zeng G, Wang Y, Ran L, Liu X. The knowledge and feeding practices of introducing complementary foods to infants in Chengdu. Chin J Child Health Care 2007;15:321–323. [In Chinese]

    Google Scholar 

  35. Zhao W, Guo S, Wang L, Zhang W, Hao B, Wu J, et al. Study on the infant complementary feeding practices in seven cities. Chin J Child Health Care 2001;9:366–369. [In Chinese]

    Google Scholar 

  36. Wang X, Kang C, Wang Y. Breastfeeding and complementary feeding in two years old children in 105 counties. Chin J Child Health Care 2000;8:144–146. [In Chinese]

    Google Scholar 

  37. Sun H, Hong Y, Xia H, Xu J, Zhang L. Survey of infant and children feeding practices and complementary feeding status. J Community Med 2011;9:57–58. [In Chinese]

    Google Scholar 

  38. Yang H, Xiao F, Li R, Zheng X, Cui M, Yin T, et al. Investigation of time to introducing complementary foods among children aged under 3 years in communities. Chin J Child Health Care 2011;19:306–308. [In Chinese]

    Google Scholar 

  39. Ogbuanu C, Glover S, Probst J, Liu J, Hussey J. The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics 2011;127:1414–1427.

    Article  Google Scholar 

  40. Tang L, Hewitt K, Yu C. Prelacteal Feeds in China. Curr Pediatr Rev 2012;8:304–312.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Li Tang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tang, L., Lee, A.H. & Binns, C.W. Factors associated with breastfeeding duration: a prospective cohort study in Sichuan Province, China. World J Pediatr 11, 232–238 (2015). https://doi.org/10.1007/s12519-014-0520-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-014-0520-y

Key words

Navigation