Breastfeeding rates and duration in Germany: a Bavarian cohort study.

Breastfeeding is the recommended feeding for all healthy infants. The aim of our study was to assess the current state of breastfeeding prevalence, duration and behaviour in Bavaria, Germany as a basis for targeting breastfeeding promotion measures. The Bavarian Breastfeeding Study is a prospective cohort study of 3822 mothers who delivered in April 2005 in Bavaria, Germany. Breastfeeding duration and determinants such as socioeconomic status, attitudes towards breastfeeding, birth mode and breastfeeding problems were assessed by questionnaires 2-6 d after birth and 2, 4, 6, and 9 months after birth. The initial breastfeeding rate was 90 %. After 4 months 61 % still breastfed (any breastfeeding). In the multivariate analyses the main influencing factor reducing breastfeeding initiation was the partner's negative attitude towards breastfeeding (OR 21.79; 95 % CI 13.46, 35.27). No initial breastfeeding was also associated with lower education, maternal grandmother's negative attitude and pre-term birth. Protective factors were primary breastfeeding experience and information on breastfeeding before birth. Breastfeeding duration < 4 months was strongly associated with breastfeeding problems (OR 7.56; 95 % CI 6.21, 9.19), smoking, lower education, partner's negative attitude and Caesarean section. Since the attitude of family members is an important influencing factor on breastfeeding rates, breastfeeding promotion should also target the partners of pregnant women and the families of newborn infants. Public health interventions such as more effective support for the management of breastfeeding problems, especially in lower social status families, should be implemented and their effectiveness should be critically evaluated.