The relationship between vulnerability factors and breastfeeding outcome

Objective: To determine whether vulnerability factors (confidence with breastfeeding, postpartum depression, supplementation, and perceived adequacy of support) are associated with breastfeeding outcome at 6 weeks postpartum after controlling for age and education. Design: Secondary analysis of a cross-sectional telephone survey at 6 weeks postpartum. Setting: Ottawa-Carleton, Ontario, Canada. Participants: A proportionate, consecutive sample of breastfeeding women from each of four hospitals in the region (526/554, 95% response rate). Methods: Stratified bivariate analyses were used to examine the relationship between each factor and breastfeeding outcome. Multivariate logistic regression analyses examined relationships between all factors and breastfeeding outcome. Results: In the logistic regression analyses, confidence with breastfeeding (odds ratio: 1.85, 95% confidence interval: 1.50-2.27, p < .001) and postpartum depression (odds ratio: 0.28, 95% confidence interval: 0.11-0.71, p = .007) were related to breastfeeding after controlling for age and education. Conclusions: Support for breastfeeding should include assessment of maternal confidence with breastfeeding and postpartum depression. Evaluation of intervention strategies to address these vulnerability factors is a priority.