title: [Malama project in the Region of Murcia (Spain): environment and breastfeeding].
abstract: OBJECTIVE
  To identify protective factors and risk factors for the initiation and length of breastfeeding and full breastfeeding, in the Region of Murcia (Spain).
  
  
  METHODS
  The Malama study (Medio Ambiente y Lactancia Materna) is a follow up study from birth up to years of 1,000 mother-child pairs. A description of breastfeeding practices are presented here, the survival curve of breastfeeding and a Cox regression model of the pilot study that includes 101 mother-child pairs and 6 months of follow-up.
  
  
  RESULTS
  After six months the prevalence of breastfeeding was 35 %. The mean duration of full breastfeeding was 63 days (median 45 days) with six months prevalence of 8 %. Hazard ratios (HR) for full breastfeeding were, to be a smoker (1.89; 95 % CI: 1.18-3.02), older than 35 years of age (2.04; 95 % CI: 1.22-3.42), caesarean birth (1.63; 95 % CI: 1.00-2.66). As well as those previously mentioned risks for breastfeeding, there were also hazard ratios for primary school education or less (1.63; 95 % CI: 0.98-2.82); to have breastfed an earlier child for at least 16 weeks (0.33; 95 % CI: 0.13-0.79), and to be the first birth (0.50; 95 % CI: 0.27-0.95). The length of both breastfeeding and full breastfeeding increased with the length of the maternal leave (0.96; 95 % CI: 0.94-0.99). Pregestational occupational exposure to endocrine disruptors did not seem to interfere with the duration of breastfeeding.
  
  
  CONCLUSIONS
  In order to improve quality and duration of breastfeeding programmes, paediatric research and training on breastfeeding practice should be encouraged, to reduce unnecessary caesarean sections, promote tobacco cessation, focus human and economic resources to women with less education, and include legal mechanisms to ensure longer maternal leave.
authors.affiliation: Pediatric Environmental Health Speciality Unit Murcia (PEHSU-Murcia), Unidad de Salud Medioambiental Pediátrica, Murcia, España. ortega@pehsu.org
authors.forename: J A
authors.initials: JA
authors.lastname: Ortega García
authors.forename: E
authors.initials: E
authors.lastname: Pastor Torres
authors.forename: I
authors.initials: I
authors.lastname: Martínez Lorente
authors.forename: V
authors.initials: V
authors.lastname: Bosch Giménez
authors.forename: J J
authors.initials: JJ
authors.lastname: Quesada López
authors.forename: F
authors.initials: F
authors.lastname: Hernández Ramón
authors.forename: M
authors.initials: M
authors.lastname: Alcaráz Quiñonero
authors.forename: M M
authors.initials: MM
authors.lastname: Llamas del Castillo
authors.forename: A M
authors.initials: AM
authors.lastname: Torres Cantero
authors.forename: R
authors.initials: R
authors.lastname: García de León González
authors.forename: M
authors.initials: M
authors.lastname: Sánchez Solís de Querol
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002391:Catchment Area, Health; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology