title: Risk of breastfeeding cessation among low-income women, infants, and children: a discrete time survival analysis.
abstract: BACKGROUND
  Women who receive services from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) often stop breastfeeding earlier than recommended. Little is known about maternal background and intrapersonal variables that predict the timing of breastfeeding cessation over the 12-month postpartum period.
  
  
  OBJECTIVE
  The aim of this study was to identify the maternal background and intrapersonal predictors associated with the timing of breastfeeding cessation in WIC participants over the course of the 12-month postpartum period.
  
  
  METHODS
  Existing longitudinal survey and administrative data from low-income breastfeeding WIC recipients (n = 309) were analyzed using discrete time survival analysis. Risk of breastfeeding cessation was the outcome, and self-reported items were used to derive predictor variables that corresponded to the background and intrapersonal variables of the Interaction Model of Client Health Behavior.
  
  
  RESULTS
  Rates of breastfeeding were low (31% at 6 months and 6% at 12 months). In the best fitting discrete time survival analysis model, women who were older and of Mexican ethnicity, who had previous breastfeeding experience, and who had breastfeeding support from family or friends were at lowest risk for breastfeeding cessation at each monthly interval.
  
  
  CONCLUSIONS
  Breastfeeding duration rates were lower than Healthy People 2020 benchmarks of 61% at 6 months and 34% at 12 months. Clinicians and researchers can use the findings from this study to develop interventions that are targeted to periods of greatest risk of premature breastfeeding cessation to prolong breastfeeding duration in this vulnerable population.
authors.affiliation: School of Nursing, Loyola University Marcella Niehoff, Maywood, Illinois 60153, USA. stenfelde@luc.edu
authors.forename: Sandi M
authors.initials: SM
authors.lastname: Tenfelde
authors.forename: Lorna
authors.initials: L
authors.lastname: Finnegan
authors.forename: Arlene Michaels
authors.initials: AM
authors.lastname: Miller
authors.forename: Pamela D
authors.initials: PD
authors.lastname: Hill
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000523:psychology / Q000706:statistics & numerical data*; D041943:Infant Formula / Q000008:administration & dosage*; D007231:Infant, Newborn; D008425:Maternal Behavior / Q000523:psychology; D009035:Mothers / Q000523:psychology*; D011203:Poverty / Q000706:statistics & numerical data*; D011632:Public Assistance / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D055815:Young Adult