title: Risk factors for cessation of breastfeeding prior to six months postpartum among a community sample of women in Calgary, Alberta.
abstract: OBJECTIVE
  To describe the rates of breastfeeding initiation and breastfeeding for at least six months and identify risk factors for failing to breastfeed for six months among a community sample of mothers in Calgary, Alberta.
  
  
  METHODS
  A cohort of women (n=1737) who participated in a longitudinal study of prenatal support and who could be contacted when their child was three-years-old (n=1147) were invited to participate in a follow-up telephone questionnaire. Of these 1147 women, 780 (69% participating rate) participated and provided breastfeeding data. Risk factors for early cessation of breastfeeding prior to six months were identified using bivariate and multivariable strategies.
  
  
  RESULTS
  Of the 780 women, 95.6% initiated breastfeeding and 71.6% continued to breastfeed for at least six months. Risk factors identified for early cessation included younger maternal age, obesity prior to pregnancy, lower maternal education, working full-time or intending to within the first year, history of depression, depression or anxiety during pregnancy, poor social support, and smoking during pregnancy (all p<0.05). Multivariable analysis revealed that working full-time or intending to within the first year, lower maternal education, obesity prior to pregnancy and anxiety during pregnancy most increased a woman's risk of early cessation (all p<0.05).
  
  
  CONCLUSIONS
  Nearly all mothers initiated breastfeeding and 70% continued to breastfeed for six months, although subgroups of women remained at an elevated risk of early cessation. Research to better understand breastfeeding decisions among women with the risk factors identified is needed to facilitate the development of more effective breastfeeding promotion strategies.
authors.affiliation: Decision Support Research Team, Calgary Health Region, Calgary, AB. heather.kehler@albertahealthservices.ca
authors.forename: Heather L
authors.initials: HL
authors.lastname: Kehler
authors.forename: Katie H
authors.initials: KH
authors.lastname: Chaput
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Tough
mesh_terms: D000416:Alberta; D001007:Anxiety / Q000150:complications / Q000523:psychology; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology*; D003863:Depression / Q000150:complications / Q000523:psychology; D004651:Employment / Q000523:psychology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015999:Multivariate Analysis; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011295:Prenatal Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors