title: Optimal periods of exclusive breastfeeding associated with any breastfeeding duration through one year.
abstract: OBJECTIVE
  To quantify optimal minimum durations of exclusive breastfeeding associated with maintenance of any breastfeeding at 15 time points during the first year of life.
  
  
  METHODS
  Mothers (n = 1189) from the prospective Infant Feeding Practices Study II cohort who initiated exclusive breastfeeding with healthy term infants were included. In a 80:20 split-sample validation study, receiver operating characteristic curves estimated optimal minimum durations of exclusive breastfeeding needed to predict maintenance of any breastfeeding at 15 time points during the first year (n = 951). Logistic regression estimated the predictive performance of the identified thresholds adjusted for maternal age, race, education, parity, support system, and return-to-work status. Results were validated in the remaining 20% (n = 238).
  
  
  RESULTS
  Optimal minimum durations ranged from 4.0-17.1 weeks of exclusive breastfeeding associated with maintenance of any breastfeeding at 15 time points. All estimated threshold durations were statistically significant after adjustment.
  
  
  CONCLUSIONS
  Using a methodological approach unique to breastfeeding duration research, the authors report optimal durations of exclusive breastfeeding associated with duration of any breastfeeding at time points throughout the first year. Perinatal clinicians, pediatricians, lactation professionals, policymakers, researchers, and families might apply these findings to achieve desirable collective breastfeeding duration outcomes.
authors.affiliation: Division of Neonatology, The Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT. Electronic address: EBrownell@ConnecticutChildrens.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Brownell
authors.affiliation: Division of Neonatology, The Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: James I
authors.initials: JI
authors.lastname: Hagadorn
authors.affiliation: Division of Neonatology, The Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, CT.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Lussier
authors.affiliation: Department of Statistics, University of Connecticut, Storrs, CT.
authors.forename: Gyuhyeong
authors.initials: G
authors.lastname: Goh
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, NY.
authors.forename: Kelly N
authors.initials: KN
authors.lastname: Thevenet-Morrison
authors.affiliation: Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: Trudy J
authors.initials: TJ
authors.lastname: Lerer
authors.affiliation: Division of Neonatology, The Connecticut Human Milk Research Center, Connecticut Children's Medical Center, Hartford, CT; Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT.
authors.forename: Victor C
authors.initials: VC
authors.lastname: Herson
authors.affiliation: Department of Public Health Sciences, University of Rochester, Rochester, NY; Department of Pediatrics, University of Rochester, Rochester, NY; Rochester General Hospital, Rochester, NY.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Howard
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000379:methods* / Q000523:psychology* / Q000706:statistics & numerical data*; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009035:Mothers; D011446:Prospective Studies; D012372:ROC Curve; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult