title: Breast-feeding education and support: association with the decision to breast-feed.
abstract: BACKGROUND
  Rates of breast-feeding in the United States are well below the Healthy People 2000 objective of 75% and do not meet recent American Academy of Pediatrics guidelines.
  
  
  OBJECTIVE
  To identify factors associated with the initiation and duration of breast-feeding in managed care enrollees who had had a normal vaginal delivery.
  
  
  METHODS
  Telephone survey of 5213 new mothers (4 to 6 months postpartum) enrolled in commercial managed care plans (response rate 72%).
  
  
  METHODS
  Starting breast-feeding (ever vs never) and duration of breast-feeding (< or = 6 weeks vs > 6 weeks).
  
  
  METHODS
  Logistic regression models controlling for sociodemographic variables. Given the prevalence of the outcome, odds ratios were converted to relative risks (RRs).
  
  
  RESULTS
  Seventy-five percent of respondents reported ever breast-feeding, and of those women, 75% reported breast-feeding for more than 6 weeks. In adjusted multivariate analyses, breast-feeding was affected by education, employment, and marital status. Women who were more likely to breast-feed were those who attended childbirth classes (RR, 1.16; 95% CI, 1.11 to 1.20), those who received prenatal breast-feeding advice (RR, 1.24; CI, 1.19 to 1.27), and those who received postpartum breast-feeding assistance (RR, 1.31; CI, 1.15 to 1.34). Breast-feeding for more than 6 weeks postpartum was associated with education, employment status, and the adequacy of postpartum information.
  
  
  CONCLUSIONS
  These findings suggest that health plans and employees may promote breast-feeding by providing breast-feeding education and support.
authors.affiliation: U.S. Quality Algorithms Center for Health Care, Atlanta, Ga., USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Deshpande
authors.forename: J A
authors.initials: JA
authors.lastname: Gazmararian
mesh_terms: D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006266:Health Education / Q000458:organization & administration*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008297:Male; D008329:Managed Care Programs; D009042:Motivation; D011203:Poverty; D016032:Randomized Controlled Trials as Topic; D012959:Socioeconomic Factors; D014481:United States