Breastfeeding rates and duration in Germany: a Bavarian cohort study

Breastfeeding is the recommended feeding for all healthy infants. The aim of our study was to assess the current state of breastfeeding prevalence, duration and behaviour in Bavaria, Germany as a basis for targeting breastfeeding promotion measures. The Bavarian Breastfeeding Study is a prospective cohort study of 3822 mothers who delivered in April 2005 in Bavaria, Germany. Breastfeeding duration and determinants such as socioeconomic status, attitudes towards breastfeeding, birth mode and breastfeeding problems were assessed by questionnaires 2–6 d after birth and 2, 4, 6, and 9 months after birth. The initial breastfeeding rate was 90 %. After 4 months 61 % still breastfed (any breastfeeding). In the multivariate analyses the main influencing factor reducing breastfeeding initiation was the partner's negative attitude towards breastfeeding (OR 21·79; 95 % CI 13·46, 35·27). No initial breastfeeding was also associated with lower education, maternal grandmother's negative attitude and pre-term birth. Protective factors were primary breastfeeding experience and information on breastfeeding before birth. Breastfeeding duration < 4 months was strongly associated with breastfeeding problems (OR 7·56; 95 % CI 6·21, 9·19), smoking, lower education, partner's negative attitude and Caesarean section. Since the attitude of family members is an important influencing factor on breastfeeding rates, breastfeeding promotion should also target the partners of pregnant women and the families of newborn infants. Public health interventions such as more effective support for the management of breastfeeding problems, especially in lower social status families, should be implemented and their effectiveness should be critically evaluated.

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Increasing Hospital Breastfeeding Rates Through Online Education for Staff Registered Nurses

Clinical Lactation ◽

10.1891/2158-0782.6.1.24 ◽

2015 ◽

Vol 6 (1) ◽

pp. 24-34

Author(s):

Ann Baker ◽

Yvonne Weideman ◽

Debra Facello

Keyword(s):

Online Education ◽

Registered Nurses ◽

Exclusive Breastfeeding ◽

Negative Attitude ◽

Cost Effective ◽

Breastfeeding Initiation ◽

Improvement Project ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

Clinically Significant

Background: The Baby-Friendly Hospital Initiative of 2010 recommends the proportion of mothers who breastfeed their babies in the early postpartum period should be at least 75% (Baby-Friendly USA, 2010). The exclusively breastfeeding rate at a community hospital located in the Appalachian region is 44%, well below the proposed standard. Registered nurses who lack knowledge or exhibit a negative attitude toward breastfeeding, can impede the understanding and skills necessary to empower mothers to effectively breastfeed.Purpose: This performance improvement project was designed to determine whether an online educational module was effective in increasing the knowledge and improving the attitudes of nurses working with breastfeeding mothers.Methods: A pre- and posttest design was used to evaluate nurse’s attitudes and knowledge of breastfeeding.Results: The results of the paired-sample t-test indicated a significant increase in the Breastfeeding Initiation Practice scores pre- and posttest. The exclusive breastfeeding rate had a clinically significant change from 44% to 58%.Conclusion: An online educational intervention was effective in increasing the knowledge of nurses working with breastfeeding mothers. This efficient and cost-effective intervention may be valuable to hospitals desiring to increase exclusive breastfeeding rates by increasing the knowledge and skill of staff.

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Influences of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study

Journal of Human Lactation ◽

10.1177/0890334417741434 ◽

2018 ◽

Vol 34 (3) ◽

pp. 526-534 ◽

Cited By ~ 15

Author(s):

Cheng Chen ◽

Yan Yan ◽

Xiao Gao ◽

Shiting Xiang ◽

Qiong He ◽

...

Keyword(s):

Cohort Study ◽

Regression Model ◽

Cesarean Delivery ◽

Vaginal Delivery ◽

Prospective Cohort Study ◽

Exclusive Breastfeeding ◽

Prospective Cohort ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Breastfeeding Practices

Background: Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. Methods: This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother–infant pairs in three communities in Hunan, China. Data about participants’ characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant’s birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. Results: The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p < .05). In addition, cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Conclusion: Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

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Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

BMC Public Health ◽

10.1186/s12889-020-09244-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Isabel Rodríguez-Gallego ◽

Fatima Leon-Larios ◽

Cecilia Ruiz-Ferrón ◽

Maria-de-las-Mercedes Lomas-Campos

Keyword(s):

Support Groups ◽

Exclusive Breastfeeding ◽

Intervention Group ◽

World Health ◽

Control Group ◽

Breastfeeding Initiation ◽

Primary Health ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

The Impact

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

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Association of Maternal Confidence and Breastfeeding Practices in Hispanic Women Compared to Non-Hispanic White Women

Global Pediatric Health ◽

10.1177/2333794x211062439 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110624

Author(s):

Adrienne Hoyt-Austin ◽

Sahel Hazrati ◽

Shruti Berlin ◽

Suchitra Hourigan ◽

Karen Bodnar

Keyword(s):

White Women ◽

Multinomial Logistic Regression ◽

Confidence Score ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Feeding Frequency ◽

Maternal Confidence ◽

Modifiable Factors ◽

Modifiable Factor ◽

Breastfeeding Rates

Understanding modifiable factors related to breastfeeding initiation and duration is critical to increase breastfeeding rates. Maternal parenting confidence is a modifiable factor whose association with breastfeeding duration has not previously been investigated. In a retrospective cohort of 1023 mother-infant dyads, the association between maternal confidence and breastmilk feeding at 6 and 12 months of age were analyzed. The association of breastmilk frequency categories and maternal confidence score at 6 and 12 months was examined using multinomial logistic regression stratified by race, ethnicity, and adjusted for gestational age. We found that breastmilk feeding frequency at 6 months was negatively associated with the maternal confidence score. After stratification by ethnicity, the association was no longer significant. There was no association between human milk feeding frequency at 12 months and maternal confidence score at 12 months. Our results demonstrate the need for additional research to identify modifiable factors to increase breastfeeding rates.

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Breastfeeding and the Role of Maternal Religion: Results from a National Prospective Cohort Study

10.31235/osf.io/swdce ◽

2017 ◽

Author(s):

Samuel Stroope

Keyword(s):

Cohort Study ◽

Educational Attainment ◽

Religious Affiliation ◽

Religious Attendance ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Sociodemographic Characteristics ◽

Religious Groups ◽

Conservative Protestants

BackgroundRecent research on religion and breastfeeding from a low-income, urban sample in the United States found that religious affiliation and religious attendance were associated with breastfeeding initiation.PurposeWe assessed the relationship between religion (religious affiliation and religious attendance) and breastfeeding (initiation and duration) in a nationally representative prospective cohort study. We examined whether education and other sociodemographic characteristics mediated or moderated relationships.MethodsUsing data from the National Longitudinal Survey of Youth 1979 (n = 3,719), we regressed breastfeeding initiation and breastfeeding duration for first births on religious affiliation and religious attendance, comparing conservative Protestants to other religious groups. Sociodemographic characteristics were explored as potential mediators or moderators of relationships. ResultsOther than Black Protestants, all religious groups reported higher odds of breastfeeding initiation compared to conservative Protestants (odds ratios = 1.43–3.01; all P < .01). All groups also breastfed longer than conservative Protestants, with the exception of Black Protestants and Catholics. Educational attainment explained breastfeeding initiation differences with the exception of nonaffiliates and “other” religious affiliates. Educational attainment also explained religious group breastfeeding duration differences with the exception of nonaffiliates. In our final models, regular religious attendance was not directly associated with breastfeeding, but it magnified the breastfeeding duration advantage seen among mothers who had a later age at first birth.ConclusionsThe role of educational attainment in explaining breastfeeding differences between conservative Protestants and other groups suggests educational interventions may be beneficial within this population.

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Breastfeeding in China: A Review of Changes in the Past Decade

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218234 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8234

Author(s):

Qing Li ◽

Jianli Tian ◽

Fenglian Xu ◽

Colin Binns

Keyword(s):

Recent Decade ◽

Breastfeeding Duration ◽

Development Education ◽

The Past ◽

Previous Review ◽

Breastfeeding Rate ◽

Level Of Economic Development ◽

The Mean ◽

Breastfeeding Rates ◽

Using Data

This review summarizes breastfeeding rates in China reported during the decade 2007–2018, a decade on from our previous review published in 2007. Compared with the studies undertaken before 2007 in China, recent studies are more likely to report breastfeeding rates using longer periods of observation, enabling rates to be summarized to six and 12 months postpartum in this review. There appears to have been a modest increase in breastfeeding in China. The mean duration of “any breastfeeding” was 10 months (9 to 11 months in the majority of cities), an increase compared with the previous review in which the mean of “any breastfeeding” duration was 8 months (7 to 9 months in the majority of cities). Using data from cohort studies, the proportion of infants being breastfed at 4 months increased from 78% in the earlier decade to 83% more recently. A second baby is usually breastfed for longer than the first, considering both “any” and “exclusive breastfeeding”. China is a huge country and there is considerable diversity in culture, level of economic development, education and breastfeeding rates in different areas of China, but our review suggests that there has been some improvement in the “any breastfeeding” rate in the most recent decade.

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Maternal probiotic milk intake during pregnancy and breastfeeding complications in the Norwegian Mother and Child Cohort Study

European Journal of Nutrition ◽

10.1007/s00394-019-02072-8 ◽

2019 ◽

Vol 59 (5) ◽

pp. 2219-2228

Author(s):

Sofiia Karlsson ◽

Anne-Lise Brantsæter ◽

Helle Margrete Meltzer ◽

Bo Jacobsson ◽

Malin Barman ◽

...

Keyword(s):

Cohort Study ◽

Bacterial Flora ◽

Milk Intake ◽

Breastfeeding Duration ◽

Logistic Regression Models ◽

Increased Risk ◽

Mother And Child ◽

Term Births ◽

Adjusted Logistic Regression ◽

Breastfeeding Problems

Abstract Purpose During the time of breastfeeding, a third of all women contract (or: fall ill in) mastitis—the leading cause of precocious weaning. Recent studies indicate that probiotics intake may prevent mastitis by altering the breast’s bacterial flora. The aim of this study was to examine whether probiotic milk intake during pregnancy is associated with less breastfeeding complications and longer breastfeeding duration. Methods This study included 57,134 women, with live singleton term births, participating in the Norwegian Mother and Child Cohort Study. Probiotic milk intake during the first half of pregnancy was self-reported in a validated food frequency questionnaire at gestational week 22. At 6 month postpartum, women reported complications, including mastitis, and duration and exclusivity of breastfeeding. The association between probiotic milk intake and breastfeeding complications and duration was studied by adjusted logistic regression models. Results Probiotic milk intake was associated with increased risk for mastitis [adjusted odds ratio (aOR) 1.09, 95% confidence interval (CI) 1.02–1.16] and for any breastfeeding problems during the first month (aOR 1.19, 95% CI 1.10–1.21). However, cessation of predominant (aOR 0.95, 95% CI 0.91–0.96) or any (aOR 0.79, 95% CI 0.75–0.84) breastfeeding earlier than at 4 months was less frequent in probiotic milk consumers than in non-consumers. Conclusions Even though probiotic milk intake during the first half of pregnancy was statistically associated with increased risk for breastfeeding complications, including mastitis, the association is probably not causal. Probiotics intake was namely associated with longer breastfeeding duration and there was indication of socioeconomic confounding. Further studies, i.e., large randomized-controlled trials, are needed to understand the association between probiotic intake and breastfeeding complications.

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Focused group discussion with health care staff improves breastfeeding rates in hospitalized infants

Paediatrica Indonesiana ◽

10.14238/pi57.4.2017.187-93 ◽

2017 ◽

Vol 57 (4) ◽

pp. 187

Author(s):

Agnes Yunie Purwita Sari ◽

Rosalina Dewi Roeslani ◽

Rinawati Rohsiswatmo

Keyword(s):

Health Care ◽

Group Discussion ◽

Fish Bone ◽

Care Staff ◽

Health Care Staff ◽

Breastfeeding Initiation ◽

Before And After ◽

Care Health ◽

Breastfeeding Rates ◽

Breastfeeding Problems

Background Improving breastfeeding in sick infants is essential. During the neonatal care, health care staff play an important role in promoting breastfeeding. Therefore, it is important to study in depth how healthcare staff can improve breastfeeding practice in sick neonates.Objective To compare breastfeeding rates in sick infants before and after a focused group discussion (FGD) of health care staff on how to improve breastfeeding.Methods This study was an operational study using FGD and in-depth interviews as an intervention. A fish bone diagram was used to assess problems that may prevent mothers from breastfeeding their sick infants. Breastfeeding achievement was compared before and after the FGD.Results Of 257 sick infants, 177 subjects were in the before FGD group and 80 subjects were in the after FGD group. Significantly more after FGD subjects were breastfed during hospitalization than before FGD subjects [97.5% vs. 82.9%, respectively; (x2 =9.43; P=0.002)]. Breastfeeding initiation within 0-4 hours of birth was also significantly higher in the after FGD group [10 (12.5%) vs. 6 (3.5%), respectively; (x2 = 52.5; P<0.001)]. The solutions for breastfeeding problems were: 1) support of hospital management, 2) support of healthcare workers for breastfeeding mothers, 3) support of husbands and families for breastfeeding mothers, 4) financial support, 5) other factors such as level of care and consistent FGD events, and 6) a prospective cohort study.Conclusion The FGD with health care staff significantly increases breastfeeding achievement during infant hospitalization, and accelerated breastfeeding initiation. A fish bone diagram is used to effectively assess the problems with breastfeeding programs for sick babies.

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Racial and Ethnic Differences in Breastfeeding

10.1542/9781610022873-racial ◽

2018 ◽

pp. 74-84

Author(s):

Chelsea O. McKinney ◽

Jennifer Hahn-Holbrook ◽

P. Lindsay Chase-Lansdale ◽

Sharon L. Ramey ◽

Julie Krohn ◽

...

Keyword(s):

Family History ◽

Demographic Characteristics ◽

Breastfeeding Duration ◽

Breastfeeding Initiation ◽

Black Mothers ◽

Hispanic Mothers ◽

White Mothers ◽

History Of ◽

Breastfeeding Rates ◽

Racial Ethnic

OBJECTIVES Breastfeeding rates differ among racial/ethnic groups in the United States. Our aim was to test whether racial/ethnic disparities in demographic characteristics, hospital use of infant formula, and family history of breastfeeding mediated racial/ethnic gaps in breastfeeding outcomes. METHODS We analyzed data from the Community and Child Health Network study (N = 1636). Breastfeeding initiation, postnatal intent to breastfeed, and breastfeeding duration were assessed postpartum. Hierarchical linear modeling was used to estimate relative odds of breastfeeding initiation, postnatal intent, and duration among racial/ethnic groups and to test the candidate mediators of maternal age, income, household composition, employment, marital status, postpartum depression, preterm birth, smoking, belief that “breast is best, ” family history of breastfeeding, in-hospital formula introduction, and WIC participation. RESULTS Spanish-speaking Hispanic mothers were most likely to initiate (91%), intend (92%), and maintain (mean duration, 17.1 weeks) breastfeeding, followed by English-speaking Hispanic mothers (initiation 90%, intent 88%; mean duration, 10.4 weeks) and white mothers (initiation 78%, intent 77%; mean duration, 16.5 weeks); black mothers were least likely to initiate (61%), intend (57%), and maintain breastfeeding (mean duration, 6.4 weeks). Demographic variables fully mediated disparities between black and white mothers in intent and initiation, whereas demographic characteristics and in-hospital formula feeding fully mediated breastfeeding duration. Family breastfeeding history and demographic characteristics helped explain the higher breastfeeding rates of Hispanic mothers relative to white and black mothers. CONCLUSIONS Hospitals and policy makers should limit in-hospital formula feeding and consider family history of breastfeeding and demographic characteristics to reduce racial/ethnic breastfeeding disparities.

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