title: What predicts intent to breastfeed exclusively? Breastfeeding knowledge, attitudes, and beliefs in a diverse urban population.
abstract: BACKGROUND
  Maternal knowledge and comfort with breastfeeding affect prenatal feeding intentions, and these intentions are strong predictors of feeding outcomes. However, predictors of exclusive breastfeeding intention have not been well characterized.
  
  
  METHODS
  We measured the association between intentions to exclusively breastfeed and knowledge of infant health benefits, feeding guidelines, and comfort related to breastfeeding in social settings. Participants were lower-income, ethnically diverse women in two randomized, controlled trials of breastfeeding support. We compared results with data from the national Infant Feeding Practices Study II.
  
  
  RESULTS
  Among 883 women in our trials, exclusive breastfeeding, mixed feeding, and exclusive formula feeding intentions were 45.9%, 46.1%, and 8.0%, respectively. In multivariate-adjusted models, women who disagreed that "Infant formula is as good as breastmilk" were more likely to intend exclusive breastfeeding versus exclusive formula feeding (odds ratio 3.44, 95% confidence interval 1.80-6.59) compared with women who agreed with this statement. Increasing levels of agreement that breastfed infants were less likely to develop ear infections, respiratory infections, diarrhea, and obesity were positively associated with intentions to exclusively breastfeed (p for trend < 0.001 for all). Compared with the national sample, our study participants were more likely to agree with all of these statements. Women who felt comfortable breastfeeding in public intended to exclusive breastfeed for 0.84 month longer (95% confidence interval 0.41-1.28) than those who felt uncomfortable.
  
  
  CONCLUSIONS
  Maternal knowledge about infant health benefits, as well as comfort with breastfeeding in social settings, was directly related to intention to exclusively breastfeed. Prenatal interventions that address these issues may increase exclusive breastfeeding intention and duration.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, NC 27599, USA. astuebe@med.unc.edu
authors.forename: Alison M
authors.initials: AM
authors.lastname: Stuebe
authors.forename: Karen
authors.initials: K
authors.lastname: Bonuck
mesh_terms: D001942:Breast Feeding / Q000208:ethnology*; D002755:Choice Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008425:Maternal Behavior / Q000208:ethnology*; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D011247:Pregnancy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data*