title: Determinants of successful breastfeeding initiation in healthy term singletons: a Swiss university hospital observational study.
abstract: OBJECTIVE
  Breastfeeding significantly benefits mothers and infants. We aimed to identify the determinants of its successful initiation.
  
  
  METHODS
  A retrospective study of 1893 mothers delivering healthy term singletons at a Swiss university hospital from 1/2008 to 3/2009 determined the associations between multiple breastfeeding and early postpartum parameters by univariate and multiple regression analysis.
  
  
  RESULTS
  Multiparity was associated with nursing exclusively at the breast at discharge (P<0.001), less use of maltodextrin supplement (P<0.05), bottle/cup (both P<0.001), but more pacifier use (P<0.05). Among obese mothers, nursing exclusively at the breast at discharge was less frequent, and use of all feeding aids more frequent, than among normal-weight women (both P<0.001). Neuraxial anesthesia was associated with use of maltodextrin and bottle (both P<0.05) compared to no anesthesia. Delayed first skin-to-skin contact and rooming-in for <24 h/day were each associated with maltodextrin and cup (P<0.05). Nursing exclusively at the breast at discharge was less frequent (P<0.001), and bottle use more frequent (P<0.05), in women with sore nipples than in those without.
  
  
  CONCLUSIONS
  Obesity is a potent inhibitor of breastfeeding initiation. Delivery without anesthesia by a multiparous normal-weight mother, followed by immediate skin-to-skin contact, rooming-in for 24 h/day, and dedicated nipple care, provides the best conditions for successful early postpartum breastfeeding without the need for feeding aids or nutritional supplements
authors.affiliation: Obstetric Research Unit, Department of Obstetrics, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Tabea
authors.initials: T
authors.lastname: Gubler
authors.forename: Franziska
authors.initials: F
authors.lastname: Krähenmann
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Roos
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Nicole
authors.initials: N
authors.lastname: Ochsenbein-Kölble
mesh_terms: D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D001942:Breast Feeding / Q000706:statistics & numerical data; D005260:Female; D006785:Hospitals, University; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D008297:Male; D009034:Mother-Child Relations; D009765:Obesity / Q000503:physiopathology; D010298:Parity; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D013557:Switzerland