title: Uneven chances of breastfeeding in Spain.
abstract: BACKGROUND
  No large scale studies on breastfeeding onset patterns have been carried out in Spain. This work aims to explore the prevalence and the risk factors for not initiating breastfeeding in hospitals from Catalonia (CAT) and Valencia (V), two regions accounting approximately for 30% of the annual births in Spain.
  
  
  METHODS
  The prevalence of not initiating breastfeeding was calculated by maternal/neonatal characteristics and type of hospital, and logistic regression models were used to estimate crude and adjusted risks of not breastfeeding in each region.
  
  
  RESULTS
  Prevalence of breastfeeding initiation was 81.7% and 82.5% in Catalonia and Valencia, respectively. We identified conspicuous regional differences in the adjusted-risk of not breastfeeding, especially for multiple [CAT = 3.12 (95% CI: 2.93, 3.31), V = 2.44 (95% CI: 2.23, 2.67)] and preterm and low birth weight deliveries [very preterm and very low birth weight: CAT = 7.61 (95% CI: 6.50, 8.92), V = 4.03 (95% CI: 3.13, 5.19); moderate preterm and moderate low birth weight: CAT = 4.28 (95% CI: 4.01, 4.57), V = 2.55 (95% CI:2.34, 2.79)].
  
  
  CONCLUSIONS
  Our results suggest the existence of regional variations in breastfeeding initiation in Spain. Taking into account the known short and long-term benefits of breastfeeding it is recommended that further research should explore these differences in order to prevent potential inequities in neonatal, child and adult health.
authors.affiliation: National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain. isario@isciii.es.
authors.forename: Isabel
authors.initials: I
authors.lastname: Río
authors.forename: Alvaro
authors.initials: A
authors.lastname: Luque
authors.forename: Adela
authors.initials: A
authors.lastname: Castelló-Pastor
authors.forename: María Del Val
authors.initials: Mdel V
authors.lastname: Sandín-Vázquez
authors.forename: Rosana
authors.initials: R
authors.lastname: Larraz
authors.forename: Carmen
authors.initials: C
authors.lastname: Barona
authors.forename: Mireia
authors.initials: M
authors.lastname: Jané
authors.forename: Francisco
authors.initials: F
authors.lastname: Bolúmar