Abstract
Background: There is lack of population-based studies evaluating whether predominant (Pr) vs exclusive (Ex) breastfeeding (BF) at the maternity ward may influence infants' feeding practice through the first year.
Methods: A total of 1656 Italian-speaking mothers of healthy full term singleton infants among those who delivered during November 1999 in Italy entered the study. Mothers were telephonically interviewed within 1 month of delivery and when infants were 3, 6, 9, 12 months-old. Feeding practices were classified according to the WHO criteria. Introducing formula within one month after delivery was defined “early introduction”. Outcome measures were duration of BF and time at introduction of formulas and solids. Maternal and infants' characteristics at birth and the WHO's ten steps to successful BF were considered as confounding variables.
Results: In the maternity ward ExBF was found in 57.2% (95% confidence interval [CI], 54.4–59.6%) and PrBF in 42.8% (95%CI, 40.4–45.2%) of infants. Duration (SD) of postpartum hospital stay (days) was 2.8 (1.4) and 3.0 (1.6) for infants respectively ExBF or PrBF (P=0.10). Caesarean section (P<0.0001), maternal overweight (P<0.01), non adherence to WHO's steps 6 (p<0.01), 7 (P<0.01) and 8 (p<0.01) were independently associated with PrBF. The median, 95%CI, duration (mos) of full (Ex+Pr) BF was 3.8, 3.6–4.0, in ExBF infants and 3.4, 3.2–3.6, in PrBF infants (P=0.02), but the difference was no longer significant after adjusting for confounders (P= 0.32). The median, 95%CI, age (mos) at the first introduction of formula was 4.3, 4.1–4.5, in ExBF infants and 3.4, 3.2–3.6, in PrBF infants (P<0.05). The median, 95%CI, age (mos) at introduction of solids was, respectively, 4.7 and 4.6, 4.4–4.8, (P=0.59). After adjusting for confounders, no significant difference was found between ExBF and PrBF in the maternity ward as far as duration (mos) of both BF (median, 95%CI, 6.3, 5.9–6.7, vs. 6.1, 5.7–6.6, P<0.01), and full BF (3.8, 3.6–4.0, vs 3.4, 3.2–3.6, P<0.01), and age (mos) at introduction of formula (4.3, 4.1–4.5 vs 3.4, 3.2–3.6, P<0.01) or solids (4.7, 4.5–4.9 vs 4.6, 4.4–4.8, P<0.01). PrBF infants were more likely to have formula introduced before the age of 1 month (adjusted odds ratio, 1.54, 95%CI 1.14–2.09, P<0.01).
Conclusion: In an industrialized country supply of non-milk liquids in the maternity ward may not be a major determinant for stop** BF or timing to introduce solids, but may be associated with an earlier use of formula.
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Giovannini, M., Riva, E., Banderali, G. et al. 16 Predominant Breastfeeding in The Maternity Ward and Infant's Feeding Practices Through The First Year of Life. Pediatr Res 56, 466 (2004). https://doi.org/10.1203/00006450-200409000-00039
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DOI: https://doi.org/10.1203/00006450-200409000-00039
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