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Predictors of impaired breastfeeding initiation and maintenance in a diverse sample: what is important?

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to investigate socio-demographic, medical and psychological factors that have an impact on breastfeeding.

Methods

Questionnaires were administered to 330 women prenatally (TI third trimester) and postpartum (TII 3–4 days, TIII 4 months). Medical data were collected from the hospital records. Self-reported data on initiation and maintenance of breastfeeding was collected simultaneously. Primary endpoint was breastfeeding initiation and maintenance. Data analyses were performed using Spearman’s ρ correlations between breastfeeding and other study variables and generalized multiple ordinal logistic regression analysis.

Results

Neonatal admission to the NICU, high BMI, cesarean section, difficulties with breastfeeding initiation and high maternal state anxiety were the strongest predictors of impaired breastfeeding initiation, explaining together 50 % of variance. After 4 months, the strongest predictors of impaired maintenance of breastfeeding were maternal smoking, a high BMI and a history of postpartum anxiety disorder, explaining 30 % of variance.

Conclusions

Successful initiation and maintenance of breast feeding is a multifactorial process. Our results underline the need of interdisciplinary approaches to optimise breastfeeding outcomes by demonstrating the equality of medical and psychological variables. Whereas practices on maternity wards are crucial for optimal initiation, continuous lifestyle modifying and supporting approaches are essential for breastfeeding maintenance. Healthcare providers can also significantly influence breastfeeding initiation and maintenance by counselling on the importance of maternal BMI.

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Acknowledgments

The Authors would like to thank Gabriele Nindl (Head of the European Institute for Breastfeeding and Lactation, EISL) and Anja Bier (EISL) for their ongoing support of this study.

Funding

Dr. Stephanie Wallwiener and Dr. Anne Doster were financially supported by the German Society of Psychosomatic Gynaecology and Obstetrics.

Authors’ contributions

S. Wallwiener: Project development, Protocol, Data management, Manuscript writing. M Mueller: Data analysis, Data management. C. Reck: Project development, Manuscript writing. C. W. Wallwiener: Manuscript editing. M. Wallwiener: Project development, Manuscript writing. K. Plewniok: Data collection and management. S. Feller: Data collection and management. H. Fluhr: Data collection. A. Doster: Data collection, Manuscript editing. S. Y. Brucker: Manuscript editing.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany

    Stephanie Wallwiener, Anne Doster, Katharina Plewniok, Herbert Fluhr, Sandra Feller & Markus Wallwiener

  2. Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany

    Mitho Müller & Corinna Reck

  3. Department of Women’s Health, University of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany

    Christian W. Wallwiener & Sara Y. Brucker

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  1. Stephanie Wallwiener
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  2. Mitho Müller
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  5. Christian W. Wallwiener
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Correspondence to Stephanie Wallwiener.

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Wallwiener, S., Müller, M., Doster, A. et al. Predictors of impaired breastfeeding initiation and maintenance in a diverse sample: what is important?. Arch Gynecol Obstet 294, 455–466 (2016). https://doi.org/10.1007/s00404-015-3994-5

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  • DOI: https://doi.org/10.1007/s00404-015-3994-5

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