Successful breastfeeding among women with intention to breastfeed: From physiology to socio-cultural factors

Background: Even if women have intention to breastfeed, they do not always achieve a successful breastfeeding. Aim: This study aims to analyse factors affecting breastfeeding prevalence among mothers that intended to breastfeed. Methods: This is a prospective observational study involving 401 pregnant women that intended to breastfeed (asked at the 20th week). Breastfeeding prevalence was evaluated in reference to health-related, socio-cultural factors and healthcare professionals' interventions at 1 month, 6 months and 12 months after birth. Data were analysed using descriptive statistical methods, bivariate logistic regression and multivariate logistic regression modelling. Results: Independent factors negatively affecting breastfeeding prevalence related to mothers' and newborns' health parameters and birth characteristics included smoking during pregnancy, anaemia and use of analgesia during labour. Regarding sociocultural parameters, being an immigrant, higher education level, intention to breastfeed before pregnancy, comfort with public breastfeeding and bedsharing were positively linked to breastfeeding, while teat or pacifier use in the first week was negatively linked. Regarding healthcare professionals' practices, mother and father/partner antenatal education course attendance and exclusive breastfeeding at the hospital were positively associated with breastfeeding. Conclusion: Breastfeeding is a very complex phenomenon affected by multiple and diverse variables. Physiological factors only affect the short term (1st month), while middle and long term BF affecting variables are mainly identical and include mostly socio-cultural factors and also BF related practices, especially in the first days after birth. These data should help to develop more effective breastfeeding promotion strategies.