title: Early exclusive breastfeeding and maternal attitudes towards infant feeding in a population of new mothers in San Francisco, California.
abstract: BACKGROUND
  Positive parental attitudes towards infant feeding are an important component in child nutritional health. Previous studies have found that participants in the Special Supplemental Women, Infants, and Children (WIC) Program have lower breastfeeding rates and attitudes that do not contribute towards healthy infant feeding in spite of breastfeeding and nutrition education programs targeting WIC participants. The objective of this study was to assess the frequency of exclusive breastfeeding in the early postpartum period and maternal attitudes towards breastfeeding in a population of mothers at two San Francisco hospitals and in relation to WIC participation status.
  
  
  METHODS
  We interviewed women who had recently delivered a healthy newborn using a structured interview.
  
  
  RESULTS
  A high percentage (79.8%) of our sample was exclusively breastfeeding at 1-4 days postpartum. We did not find any significant differences in rates of formula or mixed feeding by WIC participant status. Independent risk factors for mixed or formula feeding at 1-3 days postpartum included Asian/Pacific Islander ethnicity (odds ratio [OR] 2.90, 95% confidence interval [CI] 1.17-7.19). Being a college graduate was associated with a decreased risk of formula/mixed feeding (OR 0.28, 95% CI 0.10-0.79). We also found that thinking breastfeeding was physically painful and uncomfortable was independently associated with not breastfeeding (OR 1.41, 95% CI 1.06-1.89).
  
  
  CONCLUSIONS
  Future studies should be conducted with Asian-Americans and Pacific Islanders to better understand the lower rates of exclusive breastfeeding in this population and should address negative attitudes towards breastfeeding such as the idea that breastfeeding is painful or uncomfortable.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, 94134-0136, USA. wojcickij@peds.ucsf.edu
authors.forename: Janet M
authors.initials: JM
authors.lastname: Wojcicki
authors.forename: Roberto
authors.initials: R
authors.lastname: Gugig
authors.forename: Cam
authors.initials: C
authors.lastname: Tran
authors.forename: Suganya
authors.initials: S
authors.lastname: Kathiravan
authors.forename: Katherine
authors.initials: K
authors.lastname: Holbrook
authors.forename: Melvin B
authors.initials: MB
authors.lastname: Heyman
mesh_terms: D000328:Adult; D001213:Asian / Q000523:psychology; D001290:Attitude; D001942:Breast Feeding / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology*; D002140:California / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007224:Infant Care / Q000523:psychology*; D041943:Infant Formula / Q000008:administration & dosage* / Q000706:statistics & numerical data; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D009035:Mothers / Q000523:psychology*; D044468:Native Hawaiian or Pacific Islander / Q000523:psychology; D016017:Odds Ratio; D011632:Public Assistance