Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study, 1993-1999. Córdoba Lactation, Feeding, Growth and Development study.
The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at-risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24-48 h after birth and a follow-up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer-Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.26-2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58-6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79-4.21), the first mother-child contact occurring after 90 min of life (OR = 1.88; 95% CI 1.22-2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05-2.15). The calibration of the model was acceptable in the CLACYD I sample (p = 0.54), as well as in the CLACYD II sample (p = 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively.


CONCLUSIONS
A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.
Berra
S
S
Escuela de Nutrición, Universidad Nacional de Córdoba, Argentina.
Rajmil
L
L
Passamonte
R
R
Fernandez
E
E
Sabulsky
J
J
D001118:Argentina; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014504:Urban Health; D014886:Weaning