Stephanie Wallwiener1, Mitho Müller2, Anne Doster3, Katharina Plewniok3, Christian W Wallwiener4, Herbert Fluhr3, Sandra Feller3, Sara Y Brucker4, Markus Wallwiener3, Corinna Reck2. 1. Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. Stephanie.Wallwiener@googlemail.com. 2. Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany. 3. Department of Obstetrics and Gynecology, University of Heidelberg, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany. 4. Department of Women's Health, University of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany.
Abstract
PURPOSE: This study aimed to investigate socio-demographic, medical and psychological factors that have an impact on breastfeeding. METHODS: Questionnaires were administered to 330 women prenatally (TI third trimester) and postpartum (TII 3-4 days, TIII 4 months). Medical data were collected from the hospital records. Self-reported data on initiation and maintenance of breastfeeding was collected simultaneously. Primary endpoint was breastfeeding initiation and maintenance. Data analyses were performed using Spearman's ρ correlations between breastfeeding and other study variables and generalized multiple ordinal logistic regression analysis. RESULTS: Neonatal admission to the NICU, high BMI, cesarean section, difficulties with breastfeeding initiation and high maternal state anxiety were the strongest predictors of impaired breastfeeding initiation, explaining together 50 % of variance. After 4 months, the strongest predictors of impaired maintenance of breastfeeding were maternal smoking, a high BMI and a history of postpartum anxiety disorder, explaining 30 % of variance. CONCLUSIONS: Successful initiation and maintenance of breast feeding is a multifactorial process. Our results underline the need of interdisciplinary approaches to optimise breastfeeding outcomes by demonstrating the equality of medical and psychological variables. Whereas practices on maternity wards are crucial for optimal initiation, continuous lifestyle modifying and supporting approaches are essential for breastfeeding maintenance. Healthcare providers can also significantly influence breastfeeding initiation and maintenance by counselling on the importance of maternal BMI.
PURPOSE: This study aimed to investigate socio-demographic, medical and psychological factors that have an impact on breastfeeding. METHODS: Questionnaires were administered to 330 women prenatally (TI third trimester) and postpartum (TII 3-4 days, TIII 4 months). Medical data were collected from the hospital records. Self-reported data on initiation and maintenance of breastfeeding was collected simultaneously. Primary endpoint was breastfeeding initiation and maintenance. Data analyses were performed using Spearman's ρ correlations between breastfeeding and other study variables and generalized multiple ordinal logistic regression analysis. RESULTS: Neonatal admission to the NICU, high BMI, cesarean section, difficulties with breastfeeding initiation and high maternal state anxiety were the strongest predictors of impaired breastfeeding initiation, explaining together 50 % of variance. After 4 months, the strongest predictors of impaired maintenance of breastfeeding were maternal smoking, a high BMI and a history of postpartum anxiety disorder, explaining 30 % of variance. CONCLUSIONS: Successful initiation and maintenance of breast feeding is a multifactorial process. Our results underline the need of interdisciplinary approaches to optimise breastfeeding outcomes by demonstrating the equality of medical and psychological variables. Whereas practices on maternity wards are crucial for optimal initiation, continuous lifestyle modifying and supporting approaches are essential for breastfeeding maintenance. Healthcare providers can also significantly influence breastfeeding initiation and maintenance by counselling on the importance of maternal BMI.
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