title: Factors associated with weaning in the first 3 months postpartum.
abstract: OBJECTIVE
  To determine the demographic, behavioral, and clinical factors associated with breastfeeding termination in the first 12 weeks postpartum.
  
  
  METHODS
  This was a prospective cohort study.
  
  
  METHODS
  Breastfeeding women in Michigan and Nebraska were interviewed by telephone at 3, 6, 9, and 12 weeks postpartum or until breastfeeding termination.
  
  
  METHODS
  We measured associations of demographic, clinical, and breastfeeding variables with weaning during the first 12 weeks postpartum.
  
  
  RESULTS
  A total of 946 women participated; 75% breastfed until 12 weeks. Women older than 30 years and women with at least a bachelor's degree were more likely to continue breastfeeding in any given week. Mastitis, breast or nipple pain, bottle use, and milk expression in the first 3 weeks were all associated with termination. Beyond 3 weeks, women who expressed breast milk were 75% less likely to discontinue breastfeeding than women who did not. Women who used a bottle for some feedings during weeks 4 to 12 were 98% less likely to discontinue breastfeeding than women who did not use a bottle. "Not enough milk" was the most common reason given for termination in weeks 1 through 3 (37%) and weeks 4 through 6 (35%); "return to work" was the most common reason given in weeks 7 through 9 (53%) and weeks 10 through 12 (58%).
  
  
  CONCLUSIONS
  Younger women and less educated women need additional support in their breastfeeding efforts. Counseling and assistance should be provided to women with pain and mastitis. Exclusive breastfeeding for the first 3 weeks should be recommended. After the first 3 weeks, bottles and manual expression are not associated with weaning and may improve the likelihood of continuing breastfeeding, at least until 12 weeks.
authors.affiliation: Dept of Family Medicine, Wayne State University, 101 E. Alexandrine, Detroit, MI 48201, USA. Kensch@med.wayne.edu
authors.forename: Kendra
authors.initials: K
authors.lastname: Schwartz
authors.forename: Hannah J S
authors.initials: HJ
authors.lastname: D'Arcy
authors.forename: Brenda
authors.initials: B
authors.lastname: Gillespie
authors.forename: Janet
authors.initials: J
authors.lastname: Bobo
authors.forename: MaryLou
authors.initials: M
authors.lastname: Longeway
authors.forename: Betsy
authors.initials: B
authors.lastname: Foxman
mesh_terms: D001942:Breast Feeding; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008413:Mastitis / Q000453:epidemiology; D008824:Michigan / Q000453:epidemiology; D009329:Nebraska / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014886:Weaning