title: Breastfeeding among inner-city women: from intention before delivery to breastfeeding at hospital discharge.
abstract: OBJECTIVE
  This study assessed the degree to which women's intention to breastfeed prior to delivery translates to actual breastfeeding at hospital discharge and to investigate predictors of breastfeeding in a minority inner-city population.
  
  
  METHODS
  We conducted a retrospective cohort study of consecutive mother-infant dyads born July-September 2010 and discharged from the nursery at an academic community hospital in Philadelphia.
  
  
  RESULTS
  The demographics of the 578 women who participated included a mean age of 25.3 years (SD 6.1), 61% African American and 18% Latina, 85% covered by Medicaid, and a mean postpartum hospital stay of 2.3 days. Overall, 60% expressed an intention to breastfeed prior to delivery (exclusively or with formula), but only 50% were breastfeeding at discharge. Of those who intended to breastfeed (exclusively or with formula), 75% were breastfeeding at discharge. Of those who intended to breastfeed exclusively, 40% were doing so at discharge. Of those who intended to bottle feed, 11% were breastfeeding at discharge. In multivariable analysis, older mothers and those with lower parity were more likely to breastfeed at discharge and also to breastfeed exclusively, controlling for ethnicity, parity, insurance, pregravida body mass index, score on the Edinburgh Postpartum Depression Scale, type of delivery, infant birth weight and gestational age.
  
  
  CONCLUSIONS
  In a minority inner-city population, only three in four women who intended to breastfeed prior to delivery were breastfeeding at hospital discharge. However, one in 10 women previously not intending to breastfeed did so. Strategies are needed to promote and strengthen women's intention to breastfeed and to help women's breastfeeding outcomes meet their intentions.
authors: Department of Pediatric and Adolescent Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania 19141, USA.
authors: Shilpa G
authors: SG
authors: Hundalani
authors: Matilde
authors: M
authors: Irigoyen
authors: Leonard E
authors: LE
authors: Braitman
authors: Ramesh
authors: R
authors: Matam
authors: Stefan
authors: S
authors: Mandakovic-Falconi
mesh_terms: D000328:Adult; D001903:Bottle Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D007231:Infant, Newborn; D033182:Intention; D008429:Maternal Welfare; D008913:Minority Groups; D009034:Mother-Child Relations; D010351:Patient Discharge / Q000706:statistics & numerical data; D015143:Philadelphia / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D012944:Social Support; D014505:Urban Population