Breastfeeding prevalence and practices among Singaporean Chinese, Malay and Indian mothers

The National Breastfeeding Survey 2001 was the first comprehensive study on breastfeeding conducted on a national level in Singapore. It aimed to establish the prevalence of breastfeeding among Chinese, Malay and Indian mothers and to identify factors influencing breastfeeding. A total of 2098 mothers were interviewed in this two-phase study, with the first interview conducted 2 months after delivery and the second interview 6 months after birth among mothers who were still breastfeeding at 2 months. Frequency distributions of breastfeeding prevalence and types of breastfeeding practices at different time intervals (from birth to 6 months) were produced. Multivariate logistic regression was carried out to construct a model with predictive information on factors which influence continued breastfeeding till 2 months and 6 months after delivery respectively. The study found that about 94.5% of the mothers attempted breastfeeding. At 1 month, 71.6% were still breastfeeding, 49.6% continued to do so at 2 months, and 29.8% persisted till 4 months. By 6 months, the breastfeeding prevalence rate fell to 21.1%. The results of this study show higher breastfeeding prevalence rates compared to past studies in Singapore. Despite this, exclusive breastfeeding is still not a common practice. Various factors were found to be significant in influencing mothers' decision to breastfeed. Factors such as ethnicity, age, educational attainment, religion and baby's sex are non-modifiable in the short term or at an individual level. However, factors such as awareness of breastfeeding benefits, advice from health professionals and previous breastfeeding experience are potentially modifiable. Efforts aimed at promoting breastfeeding in Singapore need to take these modifiable factors into consideration so as to better tailor health promotion efforts on breastfeeding to women.     

The influence of psychosocial factors on the duration of breastfeeding

AIM: A study was undertaken to examine to what extent psychosocial factors are related to the length of breastfeeding. METHODS: A cohort of Danish mothers giving birth to a single child was followed up for four months. Information on mother and baby including psychosocial variables was obtained from a self-report questionnaire. Breastfeeding status was subsequently monitored by a health visitor. RESULTS: A total of 471 (88%) mothers participated, 98.7 % initiated breastfeeding and after four months 277 (59%) were still exclusive breastfeeding; 99 mothers, 51% of those who stopped, stopped within the first five weeks. In Cox regression analyses the duration of breastfeeding showed a positive association with mother's schooling (p=0.002), her intention to breastfeed (p=0.001), previous experience with breastfeeding (p<0.001), self-efficacy with respect to breastfeeding (p<0.001), her confidence in breastfeeding (p=0.012) and knowledge about breastfeeding (p=0.001). The effect of the mother's knowledge depended on the parity of the child. Among primiparous mothers high knowledge was associated with long duration of breastfeeding, but this association was not found among the multiparous. CONCLUSIONS: To help the mothers who would like to breastfeed their baby, we must improve our ability to identify mothers at risk of early cessation. Mother's schooling, her intention, self-efficacy and earlier breastfeeding experience can be used as early predictors. An intervention should aim at improving the self-efficacy and resources of these mothers, with a focus on practical knowledge. The first five weeks, when the largest proportion of the cessations occurred, require special attention.     

Association of Child Care Providers Breastfeeding Support with Breastfeeding Duration at 6 Months

Many lactating mothers participate in the workforce and have their infants cared for outside of their home, yet little is known about their child care providers’ (CCPs’) support of breastfeeding. This study examines the association between CCPs’ breastfeeding support as reported by mothers at 3 months and mother’s breastfeeding at 6 months. Infant Feeding Practices Study II, a longitudinal study, followed mothers of infants via mail questionnaires almost monthly from late pregnancy throughout the first year. This study consisted of 183 mothers who breastfed and had their infant in child care at 3 months and answered 5 questions regarding CCPs’ supports. Total number of CCPs’ support was a summary of responses to individual items and categorized into 3 levels (0–2, 3–4, or 5 total supports). Multiple logistic regressions examined how each breastfeeding support and total number were associated with breastfeeding at 6 months. Breastfeeding at 6 months was significantly associated with CCP support to feed expressed breast milk (AOR = 4.55; 95 % CI = 1.09, 18.95) and allow mothers to breastfeed at the child care place before or after work (AOR = 6.23; 95 % CI = 1.33, 29.16). Compared to mothers who reported fewer than 3 total supports, mothers who reported 5 supports were 3 times as likely to be breastfeeding at 6 months (AOR = 3.00, 95 % CI = 1.11, 8.13). Our findings suggest that CCPs’ breastfeeding support at 3 months, particularly feeding expressed breast milk and allowing mothers to breastfeed before or after work, may help mothers maintain breastfeeding at 6 months.     

A longitudinal study of breastfeeding and weaning practices during the first year of life in Dunedin,New Zealand

OBJECTIVE: To investigate infant feeding practices during the first year of life in a group of white infants in Dunedin, New Zealand. DESIGN: Prospective study of infants from birth to 12 months of age. PARTICIPANTS: A self-selected sample of 74 white mothers and their infants born in Dunedin, New Zealand, between October 1995 and May 1996. Statistical analyses Regression analyses were performed to determine factors associated with successful breastfeeding initiation and duration. RESULTS: Among mothers, 88% (n=65) initiated breastfeeding, 42% (n=31) were exclusively breastfeeding at 3 months, and 34% (n=25) were partially breastfeeding at 12 months. Intention to breastfeed increased the likelihood of successful breastfeeding initiation. Mothers who reported that they did not have enough breastmilk tended to exclusively breastfeed for a shorter period of time. Tertiary education and exclusively breastfeeding at 1 month were associated with a longer duration of breastfeeding. Perception of breastfeeding in public as embarrassing was associated with a shorter duration of breastfeeding. Among infants, 45% (n=33) were given nonmilk foods before 4 months of age, and 69% (n=51) were given unmodified cow's milk as a beverage before 12 months. APPLICATIONS: Breastfeeding rates in this study, although higher than in many Western countries, were still lower than current recommendations. Our findings suggest that women should be taught how to increase their breastmilk supply. Parents should also be informed of the importance of delaying the introduction of nonmilk foods until their infant is 4 to 6 months of age and cow's milk until they are 12 months of age. Society also needs to address the social issue of embarrassment many mothers feel when breastfeeding in public.     

Breastfeeding by Aboriginal mothers in Perth

Objective: To document the breastfeeding practices of Aboriginal mothers delivering in Perth. Design and methods: A cohort of mothers was followed from the time of delivery for six months to obtain details of infant feeding practices. Subjects: A total of 455 mothers delivered during the study period and were asked to participate. A total of 425 mothers completed the initial questionnaire. Setting: The study was undertaken in six public hospitals in Perth, Western Australia. Data analyses: The data were analysed using spss . Breastfeeding duration was calculated using Kaplan–Meier survival analysis. Main outcome measures: Breastfeeding initiation and duration. Results: The mean age of the Aboriginal mothers was 21.8 years (range 14–39 years, SD 5.32) and the average gestational age was 38.3 weeks. Almost 50% of the mothers in the study delivered by Caesarean section. At discharge from hospital 89.4% (CI 86.6–92.1) of mothers were breastfeeding, declining to 58.8% (CI 53.5–64.1) at six months. When compared with non‐Aboriginal mothers, the Aboriginal breastfeeding rates were higher than the non‐Aboriginal average breastfeeding rates, but lower than the highest socioeconomic group. Conclusions: The breastfeeding rates of Aboriginal mothers are higher than for other Australians. This is despite the low maternal age and level of education and the high rates of low‐birth‐weight infants and Caesarean section among this population. The World Health Organization recommendation for infant feeding is exclusive breastfeeding until six months, but less than one‐third of Aboriginal mothers achieved this recommendation.     

Breastfeeding duration is determined by only a few factors

BACKGROUND: According to a representative German study prepared between 1996 and 1998 (SuSe-Study) 90% of the mothers were willing to breastfeed, but only 33% (10%) of the babies were exclusively breastfed up to 4 (6) months of age. Bearing in mind that the period currently recommended for breastfeeding is 6 months, this discrepancy highlights the need for action to identify the causes. The present study investigates the behavioural pattern of mothers 4-5 months after delivery. METHODS: The investigation was carried out as a cross-sectional study of mothers who intended to breastfeed their babies (n = 52). All mothers delivered in a hospital, with maximum medical care, and were interviewed later by telephone using a semi-standardised questionnaire. The differences between actual breastfeeding mothers (BF, n = 30) and non-breastfeeding mothers (not BF, n = 22) were identified. The factors influencing decision-making were determined. RESULTS: Significant differences between the two groups tested (BF and not BF) were identified as the perception of the simplicity of breastfeeding, planned pregnancy, marital status, as well as participation at birth preparation classes. If only factors known prior to birth are applied, the decision to breastfeed can be correctly forecast as being 81%. CONCLUSION: In order to allocate consulting resources more effectively, appropriate concepts need to be developed and promoted. If the present results could be verified by a study with a larger sample, the practical use for resource optimisation in breastfeeding consultations would be very beneficial.     

Exploring the Concept of Positive Deviance Related to Breastfeeding Initiation in Black and White WIC Enrolled First Time Mothers

Positive deviance inquiry is effective in identifying advantageous health behaviors and improving health outcomes among disadvantaged resource-poor populations. The objective of this study was to apply the positive deviance concept to explore the characteristics of positive deviants for breastfeeding among WIC-enrolled first-time mothers in Louisiana. The cross sectional study included data on 2,036 WIC-enrolled first time mothers (52.6% black) from the LaPRAMs, 2000?C2004. Chi-square test was used to compare groups. Multivariable logistic regression was applied to calculate adjusted OR and 95% CI by breastfeeding initiation status. The average age was 21.3?years, 31.5% had less than 12?years of education, and 44.6% of the sample reported having initiated breastfeeding. Black mothers were less likely to initiate breastfeeding than their white counterparts (OR 0.39 (95% CI: 0.31, 0.48)). Among 641 WIC-enrolled first time mothers with less than 12?years of education, 28.4% were identified as positive deviants for breastfeeding initiation. Among the black mothers 19.8% were positive deviants compared to 40.3% of the white mothers. Breastfeeding in the hospital after delivery (P?<?0.0001) and having received help on how to breastfeed in the hospital (P?<?0.0001) were significantly associated with breastfeeding initiation in white and black mothers. In addition, the black positive deviants were more likely, OR 2.80 (95% CI: 1.20, 6.56) to have initiated breastfeeding if their baby was low birth weight. Breastfeeding practices shortly after delivery including assistance and education from staff in the hospital, are related to breastfeeding initiation among less educated WIC-enrolled mothers.     

The National Breastfeeding Policy in Nigeria: the working mother and the law

In this article, we examine the National Breastfeeding Policy in Nigeria, the extent to which the law guarantees and protects the maternity rights of the working mother, and the interplay between the law and the National Breastfeeding Policy. Our aim is to make people aware of this interplay to lead to some positive efforts to sanitize the workplace and shield women from some of the practices against them in employment relations in Nigeria as well as encourage exclusive breastfeeding by employed mothers.We conclude that the provisions of the law in this regard are not in accord with the contemporary international standards for the protection of pregnancy and maternity. It does not guarantee and protect the freedom of the nursing mother to exclusively breastfeed the child for at least the 6 months as propagated by Baby Friendly Hospital Initiative (BFHI) and the National Breastfeeding Policy. Moreover, there is no enabling law to back up the National Policy Initiative as it affects employer and employee relations. We, therefore, suggest a legal framework for effective implementation of the National Breastfeeding Policy for women in dependent labour relations. It is hoped that such laws will not only limit some of the practices against women in employment but also will encourage and promote exclusive breastfeeding behaviour by employed mothers.     

Breastfeeding Practices Among First-Time Mothers and Across Multiple Pregnancies

To investigate maternal characteristics associated with breastfeeding initiation and success. Women enrolled in the Mothers Outcomes After Delivery study reported breastfeeding practices 5?C10?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.     

Analysis of Breastfeeding Policies and Practices in Childcare Centres in Adelaide, South Australia

Breastfeeding policies and practices were analysed in childcare settings in the metropolitan area of Adelaide, South Australia. Childcare centres were purposively selected based on their geographical location, type and socioeconomic score of the area. Qualitative inquiry approach was employed by undertaking interviews with childcare centres' director or baby house coordinator to explore their perception towards breastfeeding practice and support within their centre. Breastfeeding related policy documents, where available, were also collected during the interviews to triangulate data. A total of 15 face-to-face interviews were conducted. Six childcare centres had a written policy specifically on breastfeeding support, although the technical issues of handling breastmilk were included in most centres' food and nutrition guidelines. Most participants believed that decision to breastfeed is the personal choice of parents, and hence saw the childcare centre's role as supporting parental choice whether it is breastfeeding or not. The provision of physical space to breastfeed and facilities to store the expressed breast milk were the most common practices in support of parents who had chosen to continue breastfeeding. Participants perceived mothers' work-related issues such as distance from the centre, time, and unsupportive workplace the most important barriers that led to early introduction of bottle feeding or breastfeeding cessation. Most childcare centres support breastfeeding in a more passive than active way. Breastfeeding promotion needs to be an integral part of childcare centres training, policy and practice if an increased rate of breastfeeding is to be achieved particularly amongst working mothers.     

Impact of working status on breastfeeding in Singapore: evidence from the National Breastfeeding Survey 2001

BACKGROUND: This study uses data from the 2001 Singapore National Breastfeeding Survey to examine factors, including working status, associated with breastfeeding duration. METHODS: All women who delivered in the eight hospitals with obstetric services in Singapore from 1 April to 31 May 2001 were invited to participate in a survey on infant feeding and nutrition at 2 and 6 months postpartum. A total of 2149 respondents were interviewed for variables that were known or suspected to be associated with breastfeeding initiation and duration. Cox proportional hazards model was used to determine the associated effect of working status on breastfeeding duration. Kaplan-Meier estimate and survival curves were compared between working and non-working mothers. RESULTS: Working status had no effect on initiation of breastfeeding, but had an effect on breastfeeding duration. The median breastfeeding duration for non-working and working mothers was 9 weeks and 8 weeks, respectively. This difference was significant by log rank test [hazard ratio (HR) = 1.27, 95% confidence interval (CI) 1.14-1.41, P value <0.001]. About 31% of non-working mothers breastfed for up to 6 months as compared to 20% of working mothers. Working mothers were more likely to stop breastfeeding than non-working mothers (HR = 1.61, 95% CI 1.43-1.85, P value = 0.001) after adjusting for potential confounders. The most important reason for working mothers stopping breastfeeding between 2 and 6 months was attributable to work. CONCLUSION: More breastfeeding-friendly initiatives need to be put in place at workplaces to encourage working mothers to continue breastfeeding upon returning to work.     

Breastfeeding in the Mohawk community of Kahnawake: revisited and redefined

Breastfeeding in Kahnawake, Québec, increased to 64% in 1985/1986 from 45% in 1978, and duration of breastfeeding at three and six months also improved. Breastfeeding was significantly associated with birthweight, previous nursing experience and support from baby's father. The majority of mothers chose the method of feeding prior to pregnancy and did not perceive professional advice as important. Mothers chose breastfeeding for their babies' health, and bottlefeeding for "other" reasons or so "others can feed the baby". Those who chose to breastfeed prepregnancy, breastfed significantly longer. "Lack of milk" was the predominant reason for terminating breastfeeding before three months. 29% of breastfed babies and 46% of bottlefed babies received cereal before three months. These results will be incorporated into an extended breastfeeding promotion in this community to increase the understanding of the national recommendations for universal breastfeeding, and to re-create a culturally supportive environment for breastfeeding mothers.     

The National Breastfeeding Policy in Nigeria: The Working Mother and the Law

In this article, we examine the National Breastfeeding Policy in Nigeria, the extent to which the law guarantees and protects the maternity rights of the working mother, and the interplay between the law and the National Breastfeeding Policy. Our aim is to make people aware of this interplay to lead to some positive efforts to sanitize the workplace and shield women from some of the practices against them in employment relations in Nigeria as well as encourage exclusive breastfeeding by employed mothers.

We conclude that the provisions of the law in this regard are not in accord with the contemporary international standards for the protection of pregnancy and maternity. It does not guarantee and protect the freedom of the nursing mother to exclusively breastfeed the child for at least the 6 months as propagated by Baby Friendly Hospital Initiative (BFHI) and the National Breastfeeding Policy. Moreover, there is no enabling law to back up the National Policy Initiative as it affects employer and employee relations. We, therefore, suggest a legal framework for effective implementation of the National Breastfeeding Policy for women in dependent labour relations. It is hoped that such laws will not only limit some of the practices against women in employment but also will encourage and promote exclusive breastfeeding behaviour by employed mothers.     

The factors facilitating and constraining the continuation of breastfeeding in women in Estrie (Quebec)

OBJECTIVE: To document breastfeeding rates from birth to six months as well as the factors facilitating and constraining the continuation of breastfeeding in women in the Eastern Townships of Quebec and to compare these to the results obtained in 1999. METHOD: Postal questionnaire sent to 374 mothers who had breastfed and analysis of archival data. RESULTS: Breastfeeding rates were 86.3% at birth and 75% at discharge from hospital in all mothers who gave birth to a child in 2004-2005. Breastfeeding rates in the 272 mothers who answered the questionnaire were reported to be 67.3% and 47.4% at three and six months respectively. Results indicate that 8.9% of infants were still receiving breast milk exclusively after the third month. However, 27.9% of the mothers had stopped breastfeeding during the infant's first week. Support from the nurses was the primary factor facilitating breastfeeding. The main reasons the mothers gave for stopping breastfeeding were problems with breastfeeding and fatigue. CONCLUSION: Breastfeeding rates in this area of Quebec have increased significantly in the past five years and are comparable with those in the rest of Canada. Breastfeeding exclusively up to six months is rare, and initiatives to support breastfeeding mothers in the hospital and in the community are having success.     

Breastfeeding practices and associated factors among children under 24 months of age in Timor-Leste

OBJECTIVE: To describe breastfeeding practices and to assess the sociodemographic factors associated with selected breastfeeding indicators. DESIGN AND SETTING: The 2003 Demographic and Health Survey was a multi-stage cluster sample survey of 4320 households from four different geographic areas in Timor-Leste. SUBJECTS: A total of 2162 children aged 0-23 months. RESULTS: A high proportion (97.6%) of infants had been ever breastfed, but only 46.1% had initiated breastfeeding within the first hour of birth. Seventy-eight percent of children <24 months were currently breastfed, 30.7% of infants <6 months were exclusively breastfed and 12.5% of infants <12 months were bottle-fed. A high proportion of infants of 6-9 months (82.0%) were receiving complementary food in addition to breast milk. Multivariate analysis revealed that exclusive breastfeeding was significantly lower in the rural west region (odds ratio (OR)=3.15) compared to the urban region, and among those from richest households (OR=1.90) compared to poorest. Mothers with primary education were significantly more likely to exclusively breastfeed than mothers with no education (OR=0.62). Increasing age of the infant was associated with significantly less current (OR=1.23) and exclusive (OR=1.35) breastfeeding. Continuation of breastfeeding at the end of the first year was significantly lower in non-working mothers (OR=1.58) compared to working mothers, and among infants born in health-care facilities (OR=2.16) than those born at home. CONCLUSIONS: Breastfeeding practices in Timor-Leste were satisfactory, except the exclusive breastfeeding at 6 months. However, more socioeconomically privileged groups demonstrated a poorer breastfeeding performance than disadvantaged groups. Further breastfeeding promotion programmes are needed across all population groups, and should include health-care providers and maternity institutions.     

The contribution of parental and community ethnicity to breastfeeding practices: evidence from the Millennium Cohort Study

BACKGROUND: The association of ethnic and social factors at the individual and community level with inequalities in starting, and continuing, to breastfeed remains unclear. We explored these factors using data from the Millennium Cohort Study. METHODS: We obtained data for 11 286 natural mothers [8207 (85%) white] of singleton infants, living in England at age 9 months. Breastfeeding mothers were defined as the proportion of all mothers who reported: putting their baby to the breast at least once and giving any breastmilk (initiation); and having started, continuing for at least 1 month (continuation). RESULTS: In England, 72% of all mothers started breastfeeding, and of these 70% continued for at least 1 month. White mothers were the least likely to start breastfeeding (70%), as were multiparous mothers (69%), younger mothers, those with no academic qualifications (51%), in routine occupations (59%), or living in disadvantaged communities (60%). For white mothers, having a partner of a different ethnic group was independently and positively associated with breastfeeding initiation and continuation to 1 month [adjusted rate ratios (95% CI): 1.14 (1.07-1.21) and 1.09 (1.03-1.16), respectively]. White lone mothers were more likely to initiate breastfeeding if they lived in high ethnic minority communities [adjusted rate ratio (95% CI): 1.42 (1.15-1.76)] rather than disadvantaged areas. For all mothers, maternal age at first motherhood was positively associated with breastfeeding [adjusted rate ratio (95% CI): 1.06 (1.04-1.08) per 5 year increase]. CONCLUSIONS: Significant inequalities in breastfeeding practices remain within the UK. White women are less likely to breastfeed and, for these women, partner and community ethnicity have an important relation to starting and continuing to breastfeed. Our findings suggest that public health strategies to increase breastfeeding need to be focussed on mothers who are young at first motherhood and address support offered by partners and the communities in which women live. Measures to evaluate the effectiveness of these strategies over time and between places should take account of changes in ethnic composition of the child-bearing population.     

Social and Institutional Factors that Affect Breastfeeding Duration Among WIC Participants in Los Angeles County, California

Hospital practices and early maternal return to work are associated with breastfeeding duration; however, research has not documented the long-term effects of many hospital policies or the effect of early return to work on breastfeeding outcomes of WIC participants. This study investigated the impact of in-hospital breastfeeding, receipt of a formula discharge pack, and maternal return to work on the long-term breastfeeding outcomes of 4,725 WIC participants in Los Angeles County, California. Multivariate logistic regression analyses were used to assess determinants of exclusive breastfeeding at 6?months and breastfeeding at 6, 12, and 24?months. In-hospital initiation of breastfeeding, exclusive breastfeeding in the hospital, receipt of a formula discharge pack, and maternal return to work before 3?months were all significantly associated with breastfeeding outcomes after controlling for known confounders. Mothers who exclusively breastfed in the hospital were eight times as likely as mothers who did not breastfeed in the hospital to reach the AAP recommendation of breastfeeding for 12?months or longer (P?<?.01). Only 6.9% of the sample reported exclusively breastfeeding for 6?months or more, and just one-third reported any breastfeeding at 12?months. Nine in ten respondents received a formula discharge pack in the hospital. Mothers who received a discharge pack were half as likely to exclusively breastfeed at 6?months as those who did not receive one (P?<?.01). Medical providers should educate, encourage, and support WIC mothers to breastfeed in the hospital and refrain from giving formula discharge packs.     

Breastfeeding trends and updated national health objectives for exclusive breastfeeding--United States, birth years 2000-2004

Breastfeeding is associated with decreased risk for many early-life diseases and conditions, including otitis media, respiratory tract infections, atopic dermatitis, gastroenteritis, type 2 diabetes, sudden infant death syndrome, and obesity. Breastfeeding also is associated with health benefits to women, including decreased risk for type 2 diabetes, ovarian cancer, and breast cancer. Exclusive breastfeeding is defined as an infant receiving only breast milk and no other liquids or solids except for drops or syrups consisting of vitamins, minerals, or medicines. In 2007, Healthy People 2010 (HP2010) objectives for breastfeeding initiation and duration were updated to include two new objectives on exclusive breastfeeding (i.e., to increase the proportion of mothers who exclusively breastfeed their infants through age 3 months to 60% and through age 6 months to 25% [objectives 16-19d and 16-19e]). To monitor progress toward achieving HP2010 breastfeeding objectives, CDC analyzed data from the National Immunization Survey (NIS). This report describes the results of that analysis, which indicated that rates for breastfeeding initiation and duration increased among infants born during 2000-2004. Rates for exclusive breastfeeding through ages 3 months and 6 months among infants born in 2004 were 30.5% and 11.3%, respectively, below targets set by HP2010. Rates of exclusive breastfeeding were significantly lower among black infants (compared with white infants) and infants born to unmarried mothers (compared with married mothers). Additionally, older age, urban residence, higher education, and higher income of mothers all were positively associated with exclusive breastfeeding. Further research is needed to identify successful programs and policies to support exclusive breastfeeding, especially among subgroups with the lowest rates.     

Breastfeeding among teenage and adult mothers in Brazil

OBJECTIVE: To estimate the prevalence of breastfeeding among teenage (younger than 20 years old) and adult mothers of six-month-old children and to identify factors associated with weaning. METHODS: A cross-sectional study of a sample of 237 teenage mothers and 239 adult mothers living in the city of Montes Claros, Brazil, whose babies were six-month-old at the time of the interview was carried out. Mothers answered a questionnaire at home. To assess factors associated with weaning, univariate, Mantel-Haenszel, and multiple logistic regression analyses were performed. RESULTS: Breastfeeding prevalence in children aged 6 months was 71.3% among teenage mothers and 77.4% among adult mothers (crude OR=1.38; p=0.128), but after adjusting for control variables the role of adolescence added considerable weight to weaning. Factors associated with weaning were: marital status, mother's occupation after delivery (both showed interaction with teenage years), difficulty to breastfeeding in the first days after delivery, and exclusive breastfeeding at the time of hospital discharge. CONCLUSIONS: The observed interactions with teenage in regard to weaning suggest that motherhood in this age group has unique features that should be further investigated.