title: Frequencies and demographic determinants of breastfeeding and DHA supplementation in a nationwide sample of mothers in Germany.
abstract: OBJECTIVE
  German guidelines recommend breast milk as ideal for infant's nutrition, supporting exclusive breastfeeding for at least 4 months. Moreover, in mothers with insufficient fish intake, DHA status may be improved by supplementation during pregnancy and lactation. However, little is known on current rates of breastfeeding and DHA supplementation in Germany. The objective of this study was to analyse frequencies and demographic determinants of breastfeeding and DHA supplementation in Germany.
  
  
  METHODS
  Data derived from a nationwide consumer survey of 986 mothers with children between 5 and 36 months of age in Germany.
  
  
  RESULTS
  78.3% reported that they ever breastfed their children, and 55.6% of the mothers exclusively breastfed for at least 4 months. Mothers who did not breastfeed were less likely to be informed by their paediatrician or midwife and were more often not informed at all; 27.8% of mothers used DHA supplements during pregnancy, 16.8% postnatal. DHA supplementation was more common in women with a high versus a low fish intake. The social status was the major determinant of breastfeeding initiation and exclusivity and also DHA supplementation.
  
  
  CONCLUSIONS
  Breastfeeding initiation and duration of exclusive breastfeeding in Germany need to be improved. Professional counselling and support, with a focus on mothers from lower social classes, appears necessary to increase current rates of breastfeeding initiation, duration, and exclusiveness, but also to ensure a sufficient supply with DHA in pregnant and lactating women, particularly in women with low fish consumption.
authors.affiliation: Research Institute of Child Nutrition (FKE) Dortmund, Rheinische Friedrich-Wilhelms-University Bonn, Heinstueck 11, 44225, Dortmund, Germany, libuda@fke-do.de.
authors.forename: Lars
authors.initials: L
authors.lastname: Libuda
authors.forename: Madlen
authors.initials: M
authors.lastname: Stimming
authors.forename: Christina
authors.initials: C
authors.lastname: Mesch
authors.forename: Petra
authors.initials: P
authors.lastname: Warschburger
authors.forename: Hermann
authors.initials: H
authors.lastname: Kalhoff
authors.forename: Berthold Viktor
authors.initials: BV
authors.lastname: Koletzko
authors.forename: Mathilde
authors.initials: M
authors.lastname: Kersting
mesh_terms: D000328:Adult; D001942:Breast Feeding; D002675:Child, Preschool; D003710:Demography; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D039382:Maternal Nutritional Physiological Phenomena; D008895:Milk, Human / Q000737:chemistry; D018673:Nutrition Policy; D009749:Nutrition Surveys; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004281:Docosahexaenoic Acids