title: Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia.
abstract: BACKGROUND
  Optimal breastfeeding has benefits for the mother-infant dyads. This study investigated the prevalence and determinants of cessation of exclusive breastfeeding (EBF) in the early postnatal period in a culturally and linguistically diverse population in Sydney, New South Wales, Australia.
  
  
  METHODS
  The study used routinely collected perinatal data on all live births in 2014 (N= 17,564) in public health facilities in two Local Health Districts in Sydney, Australia. The prevalence of mother's breastfeeding intention, skin-to-skin contact, EBF at birth, discharge and early postnatal period (1-4 weeks postnatal) were estimated. Multivariate logistic regression models that adjusted for confounders were conducted to determine association between cessation of EBF in the early postnatal period and socio-demographic, psychosocial and health service factors.
  
  
  RESULTS
  Most mothers intended to breastfeed (92%), practiced skin-to-skin contact (81%), exclusively breastfed  at delivery (90%) and discharge (89%). However, the prevalence of EBF declined (by 27%) at the early postnatal period (62%). Younger mothers (<20 years) and mothers who smoked cigarettes in pregnancy were more likely to cease EBF in the early postnatal period compared to older mothers (20-39 years) and those who reported not smoking cigarettes, respectively [Adjusted Odds Ratio (AOR) =2.7, 95%CI 1.9-3.8,P<0.001 and AOR = 2.5, 95%CI 2.1-3.0,P<0.001, respectively]. Intimate partner violence, assisted delivery, low socio-economic status, pre-existing maternal health problems and a lack of partner support were also associated with early cessation of EBF in the postnatal period.
  
  
  CONCLUSIONS
  Our findings suggest that while most mothers intend to breastfeed, and commence EBF at delivery and at discharge, the maintenance of EBF in the early postnatal period is sub-optimal. This highlights the need for efforts to promote breastfeeding in the wider community along with targeted actions for disadvantaged groups and those identified to be at risk of early cessation of EBF to maximise impact.
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia.|Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.
authors.forename: Felix A
authors.initials: FA
authors.lastname: Ogbo
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|School of Women's and Children's Health, The University of New South Wales, Kensington, Sydney, NSW Australia.|Menzies Centre for Health Policy, Charles Perkins Centre, School of Public Health, Sydney University, Sydney, NSW Australia.|School of Public Health, Griffith University, Gold Coast, QLD Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.|Sydney Children's Hospital Network, Randwick, NSW Australia.
authors.forename: John
authors.initials: J
authors.lastname: Eastwood
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia.|Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, NSW Australia.
authors.forename: Amit
authors.initials: A
authors.lastname: Arora
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia.
authors.forename: Anne
authors.initials: A
authors.lastname: McKenzie
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Healthy People and Places Unit, South Western Sydney Local Health, Liverpool, NSW Australia.
authors.forename: Bin
authors.initials: B
authors.lastname: Jalaludin
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Elaine
authors.initials: E
authors.lastname: Tennant
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Miller
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|School of Psychiatry, UNSW Medicine, University of New South Wales, Randwick, NSW Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Kohlhoff
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Justine
authors.initials: J
authors.lastname: Noble
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Karina
authors.initials: K
authors.lastname: Chaves
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Jones
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Women and Child Health, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia.
authors.forename: John
authors.initials: J
authors.lastname: Smoleniec
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Peadiatrics and Neonatology, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, NSW Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Chay
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Smith
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Newborn Care, Royal Hospital for Women, Randwick, NSW Australia.
authors.forename: Ju-Lee
authors.initials: JL
authors.lastname: Oei
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Short
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Department of Community Paediatrics, Sydney Local Health District, Croydon Community Health Centre, Croydon, NSW Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Collie
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Translational Research and Social Innovation, School of Nursing and Midwifery, Western Sydney University, Penrith, NSW Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Kemp
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Community Paediatrician for Child Protection, South Western Sydney Local Health District, Liverpool, NSW Australia.|Maari Ma Health Aboriginal Corporation, Broken Hill, NSW Australia.
authors.forename: Shanti
authors.initials: S
authors.lastname: Raman
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|School of Women's and Children's Health, The University of New South Wales, Kensington, Sydney, NSW Australia.|Department of Community Child Health/Integrated Care, Sydney Children's Hospital Network, High Street, Randwick, NSW 2031 Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Woolfenden
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia.
authors.forename: Trish
authors.initials: T
authors.lastname: Clark
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Child and Family Health Nursing, Primary & Community Health, South Western Sydney Local Health District, Narellan, NSW Australia.
authors.forename: Victoria
authors.initials: V
authors.lastname: Blight
authors.affiliation: Ingham Institute for Applied Medical Research, Liverpool, NSW Australia.|Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, Liverpool Hospital, Liverpool, NSW Australia.
authors.forename: Valsamma
authors.initials: V
authors.lastname: Eapen
keywords: Australia; Cessation; Exclusive breastfeeding; Sydney; postnatal period