title: Factors affecting breast-feeding initiation in Greece: What is important?
abstract: OBJECTIVE
  to investigate the association between breast-feeding initiation and socio-demographic, lifestyle-related, clinical and lactation-related factors in a sample of mothers living in Greece.
  
  
  METHODS
  cross-sectional study.
  
  
  METHODS
  Tertiary University Hospital, maternity ward.
  
  
  METHODS
  428 mothers were interviewed (43.2% response rate) from February until December 2009, using a structured face-to-face questionnaire after at least 24 hours from childbirth.
  
  
  RESULTS
  71.0% of mothers were Greeks and 29.0% immigrants; the mean age was 32.0 years. 44.4% initiated exclusive breast feeding, 7.9% artificial milk -feeding and 47.7% partial feeding. In the multivariate analysis, exclusive breast feeding was inversely related to maternal body mass index (BMI) at the beginning of gestation (odds ratio (OR)=0.93, 95% confidence intervals (95%CI)=0.89-0.98) and caesarean section (OR=0.54, 95% CI=0.35-0.84). Lactation-related factors which favourably affected exclusive breast-feeding initiation included previous breast-feeding experience (OR=2.29, 95% CI=1.39-3.78), information about breast feeding (OR=2.38, 95% CI=1.41-4.01) and rooming-in (OR=1.62 95% CI=1.03-2.54), whilst any breast feeding was favourably affected by encouraging women to breast feed (OR=5.42, 95% CI=1.90-15.50), providing information about breast feeding (OR=6.92, 95% CI=2.53-18.89), and rooming-in (OR=6.93 95% CI=2.01-23.88), and negatively associated with caesarean section (OR=0.11, 95% CI=0.03-0.39). Being an immigrant mother was also positively associated with any breast-feeding initiation (OR=7.97, 95% CI=1.02-62.19). Maternal age, education and income, as well as, smoking status, were not associated with any breast-feeding initiation.
  
  
  CONCLUSIONS
  maternal BMI and immigrant status, information provided by midwives and encouragement, rooming-in and mode of childbirth (caesarean section), were found to be important for breast-feeding initiation in this study population. No other indicator of socio-demographic status was found to be associated with breast-feeding initiation.
  
  
  CONCLUSIONS
  focus should be given to pregnant women with higher BMI at the beginning of pregnancy, and women who had undergone caesarean section. Breast-feeding information and encouragement should be provided to all women in the maternity ward, along with the dedicated practice of rooming-in, in order to promote and increase breast-feeding initiation rates.
authors.affiliation: Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece.
authors.forename: Evangelia-Filothei
authors.initials: EF
authors.lastname: Tavoulari
authors.affiliation: Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Benetou
authors.affiliation: ENT Department, MITERA Paediatric Infirmary, Athens, Greece. Electronic address: pevlast@hotmail.com.
authors.forename: Petros V
authors.initials: PV
authors.lastname: Vlastarakos
authors.affiliation: Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Andriopoulou
authors.affiliation: 2nd OBG Department, Aretaieion University Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kreatsas
authors.affiliation: Department of Hygiene, Epidemiology & Medical Statistics, University of Athens, Greece.
authors.forename: Athena
authors.initials: A
authors.lastname: Linos
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008423:Maternal Age; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D012959:Socioeconomic Factors
keywords: Artificial milk; Breast feeding; Exclusive; Lactation; Mother; Newborn