title: Determinants of exclusive breastfeeding cessation: identifying an "at risk population" for special support.
abstract: A study was conducted with 542 women, who gave birth in the hospital G.B. Grassi in Rome, to investigate risk factors for exclusive breastfeeding. Clinical data was collected from clinical records at delivery. Information on psycho-socio-demographic characteristics was obtained by standardized questionnaires at delivery. Data on breastfeeding practice and the use of pacifier were collected at delivery and for 24 weeks' postpartum. The outcome of the study was exclusive breastfeeding for at least 4 months (yes/no). In the multivariate analysis, planned caesarean (OR 2.40, 95 % CI 1.06-5.43) and women with two or more psychological distress conditions (past episodes of depression, insomnia, perceive birth as a traumatic event) versus none were at a greater odds of stopping exclusive breastfeeding before 4 months (OR 3.42, 95 % CI 1.15-10.2). The use of pacifiers within the first 2 weeks postpartum (OR 2.38, 95 % CI 1.35-4.20) but not after 2 weeks (OR 0.86, 95 % CI 0.43-1.72) versus no use was also associated with an increased odds. A protective effect was found for antenatal classes (OR 0.57, 95 % CI 0.35-0.95).
  
  
  CONCLUSIONS
  This study suggests that the type of delivery, antenatal classes, psychological distress conditions and the use of pacifiers in the first 2 weeks of a baby's life are independent factors associated with exclusive breastfeeding.
authors.affiliation: NESMOS Department (Neurosciences, Mental Health and Sensory Functions), 2nd Medical School, Sant'Andrea Hospital, Sapienza University, Rome, Italy, juliana_lindau@hotmail.com.
authors.forename: Juliana F
authors.initials: JF
authors.lastname: Lindau
authors.forename: Simona
authors.initials: S
authors.lastname: Mastroeni
authors.forename: Andrea
authors.initials: A
authors.lastname: Gaddini
authors.forename: Domenico
authors.initials: D
authors.lastname: Di Lallo
authors.forename: Paolo
authors.initials: P
authors.lastname: Fiori Nastro
authors.forename: Paolo Fiori
authors.initials: PF
authors.lastname: Nastro
authors.forename: Martina
authors.initials: M
authors.lastname: Patanè
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.forename: Cristina
authors.initials: C
authors.lastname: Fortes
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014886:Weaning