Factors affecting breast-feeding initiation in Greece: What is important?

Objectiveto investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece.Designcross-sectional study.SettingTertiary University Hospital, maternity ward.Participants428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth.Measurements and findings71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89–0.98) and caesarean section (OR=0.54, 95% CI=0.35–0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39–3.78), information about breast feeding (OR=2.38, 95% CI=1.41–4.01) and rooming-in (OR=1.62 95% CI=1.03–2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90–15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53–18.89), and rooming-in (OR=6.93 95% CI=2.01–23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03–0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02–62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation.Key conclusionsmaternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast-feeding initiation.Implications for practicefocus should be given to pregnant women with higher BMI at the beginning of pregnancy, and women who had undergone caesarean section. Breast-feeding information and encouragement should be provided to all women in the maternity ward, along with the dedicated practice of rooming-in, in order to promote and increase breast-feeding initiation rates.