Determinants of exclusive breastfeeding cessation: identifying an at risk population for special support

A study was conducted with 542 women, who gave birth in the hospital G.B. Grassi in Rome, to investigate risk factors for exclusive breastfeeding. Clinical data was collected from clinical records at delivery. Information on psycho-socio-demographic characteristics was obtained by standardized questionnaires at delivery. Data on breastfeeding practice and the use of pacifier were collected at delivery and for 24 weeks' postpartum. The outcome of the study was exclusive breastfeeding for at least 4 months (yes/no). In the multivariate analysis, planned caesarean (OR 2.40, 95 % CI 1.06-5.43) and women with two or more psychological distress conditions (past episodes of depression, insomnia, perceive birth as a traumatic event) versus none were at a greater odds of stopping exclusive breastfeeding before 4 months (OR 3.42, 95 % CI 1.15-10.2). The use of pacifiers within the first 2 weeks postpartum (OR 2.38, 95 % CI 1.35-4.20) but not after 2 weeks (OR 0.86, 95 % CI 0.43-1.72) versus no use was also associated with an increased odds. A protective effect was found for antenatal classes (OR 0.57, 95 % CI 0.35-0.95). Conclusion: This study suggests that the type of delivery, antenatal classes, psychological distress conditions and the use of pacifiers in the first 2 weeks of a baby's life are independent factors associated with exclusive breastfeeding.