title: Breastfeeding initiation in a rural sample: predictive factors and the role of smoking.
abstract: The study objective was to identify demographic, medical, and health behavior factors that predict breastfeeding initiation in a rural population with low breastfeeding rates. Participants were 2323 women who experienced consecutive deliveries at 2 hospitals, with data obtained through detailed chart review. Only half the women initiated breastfeeding, which was significantly associated with higher levels of education, private insurance, nonsmoking and non-drug-using status, and primiparity, after controlling for confounders. Follow-up analyses revealed that smoking status was the strongest predictor of failure to breastfeed, with nonsmokers nearly twice as likely to breastfeed as smokers and with those who had smoked a pack per day or more the least likely to breastfeed. Findings reveal many factors placing women at risk for not breastfeeding and suggest that intervention efforts should encourage a combination of smoking cessation and breastfeeding while emphasizing that breastfeeding is not contraindicated even if the mother continues to smoke.
authors.affiliation: Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Bailey
authors.forename: Heather N
authors.initials: HN
authors.lastname: Wright
mesh_terms: D000328:Adult; D001061:Appalachian Region / Q000453:epidemiology; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006801:Humans; D017533:Marital Status; D011237:Predictive Value of Tests; D012424:Rural Population / Q000706:statistics & numerical data*; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D055815:Young Adult