Women's intentions to breastfeed: a population‐based cohort study

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 120; no. 12; pp. 1490 - 1499
• Main Authors: Lutsiv, O, Pullenayegum, E, Foster, G, Vera, C, Giglia, L, Chapman, B, Fusch, C, McDonald, SD
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-11-2013
• Subjects: Adult; Breast Feeding - psychology; Breastfeeding; Breastfeeding & lactation; Female; Hospitalization - statistics & numerical data; Humans; Intention; Maternal Age; Objectives; Ontario; population‐based; Pregnancy; Pregnancy, Multiple - psychology; Pregnancy, Multiple - statistics & numerical data; Pregnant Women - psychology; Premature Birth - psychology; Prenatal Care - statistics & numerical data; prevalence; Retrospective Studies; Socioeconomic Factors; Ontario; Canada; prevalence; Breastfeeding; population-based; intention
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.12376

Objective
Given that intention to breastfeed is a strong predictor of breastfeeding initiation and duration, the objectives of this study were to estimate the population‐based prevalence and the factors associated with the intention to breastfeed.
Design
Retrospective population‐based cohort study.
Setting
All hospitals in Ontario, Canada (1 April 2009–31 March 2010).
Population
Women who gave birth to live, term, singletons/twins.
Methods
Patient, healthcare provider, and hospital factors that may be associated with intention to breastfeed were analysed using univariable and multivariable regression.
Main outcome measures
Population‐based prevalence of intention to breastfeed and its associated factors.
Results
The study included 92 364 women, of whom 78 806 (85.3%) intended to breastfeed. The odds of intending to breastfeed were higher amongst older women with no health problems and women who were cared for exclusively by midwives (adjusted OR 3.64, 95% CI 3.13–4.23). Being pregnant with twins (adjusted OR 0.73, 95% CI 0.57–0.94), not attending antenatal classes (adjusted OR 0.58, 95% CI 0.54–0.62), having previous term or preterm births (adjusted OR 0.79, 95% CI 0.78–0.81, and adjusted OR 0.87, 95% CI 0.82–0.93, respectively), and delivering in a level–1 hospital (adjusted OR 0.85, 95% CI 0.77–0.93) were associated with a lower intention to breastfeed.
Conclusions
In this population‐based study ~85% of women intended to breastfeed their babies. Key factors that are associated with the intention to breastfeed were identified, which can now be targeted for intervention programmes aimed at increasing the prevalence of breastfeeding and improving overall child and maternal health.