Article Text

Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks: the Feeding Your Baby (FYB) cohort study
  1. Peter T Donnan1,
  2. Janet Dalzell2,
  3. Andrew Symon3,
  4. Petra Rauchhaus1,
  5. Ewa Monteith-Hodge3,
  6. Gillian Kellett3,
  7. Jeremy C Wyatt4,
  8. Heather M Whitford3
  1. 1Dundee Epidemiology and Biostatistics Unit, Division of Population Health Sciences, Medical Research Institute, University of Dundee, Dundee, Scotland, UK
  2. 2Directorate of Public Health, NHS, Tayside, Scotland, UK
  3. 3School of Nursing and Midwifery, University of Dundee, Dundee, Scotland, UK
  4. 4Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
  1. Correspondence to Dr Heather M Whitford; h.m.whitford{at}dundee.ac.uk

Abstract

Objective To derive prediction models for both initiation and cessation of breastfeeding using demographic, psychological and obstetric variables.

Design A prospective cohort study.

Setting Women delivering at Ninewells Hospital, Dundee, UK.

Data sources Demographic data and psychological measures were obtained during pregnancy by questionnaire. Birth details, feeding method at birth and at hospital discharge were obtained from the Ninewells hospital database, Dundee, UK. Breastfeeding women were followed up by text messages every 2 weeks until 16 weeks or until breastfeeding was discontinued to ascertain feeding method and feeding intentions.

Participants Pregnant women over 30 weeks gestation aged 16 years and above, living in Dundee, booked to deliver at Ninewells Hospital, Dundee, and able to speak English.

Main outcome measure Initiation and cessation of breastfeeding.

Results From the total cohort of women at delivery (n=344) 68% (95% CI 63% to 73%) of women had started breastfeeding at discharge. Significant predictors of initiating breastfeeding were older age, parity, greater intention to breastfeed from a Theory of Planned Behaviour (TPB)-based questionnaire, higher Iowa Infant Feeding Assessment Scale (IIFAS) score as well as living with a husband or partner. For the final model, the AUROC was 0.967. For those who initiated breastfeeding (n=233), the strongest predictors of stopping were low intention to breastfeed from TPB, low IIFAS score and non-managerial/professional occupations.

Conclusions The findings from this study will be used to inform the protocol for an intervention study to encourage and support prolonged breastfeeding as intentions appear to be a key intervention focus for initiation. The predictive models could be used to identify women at high risk of not initiating and also women at high risk of stopping for interventions to improve the longevity of breastfeeding.

  • Public Health
  • Nutrition & Dietetics

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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