title: Changes in breastfeeding initiation at hospital discharge between first and second births in Nova Scotia: a population-based cohort study.
abstract: BACKGROUND
  Breastfeeding has well-recognized health benefits for infants and mothers. However, little research has been conducted to investigate changes in breastfeeding from one pregnancy to another. This study was conducted to describe rates of breastfeeding initiation at hospital discharge for women's first and second births and to identify factors associated with changes in initiation at the second birth.
  
  
  METHODS
  We conducted a longitudinal, population-based cohort study involving women residing in Nova Scotia who delivered a first and second live-born singleton between 2007 and 2013. Separate analyses were conducted among women who breastfed their first infant and among women who did not breastfeed their first infant.
  
  
  RESULTS
  Of the 9643 (82.6%) mothers who initiated breastfeeding in the first birth, 973 (10.3%) did not initiate breastfeeding in the second birth. Of first-birth noninitiators, 526 (26.3%) initiated breastfeeding in the second birth. With the exception of smoking and cesarean births, factors that were associated with breastfeeding initiation in the second birth depended on breastfeeding initiation status in the first birth. These factors were associated with increased odds of not breastfeeding in the second birth among the subset of mothers who breastfed in the first birth, and decreased odds of breastfeeding in the second birth among the subset of mothers who did not breastfeed in the first birth.
  
  
  CONCLUSIONS
  Most women continue the same method of infant feeding after their first and second births. Identifying factors associated with change in breastfeeding status between the first and second births may help to inform interventions for optimal breastfeeding initiation in the second birth.
authors.affiliation: Faculty of Medicine (Nix); Departments of Obstetrics & Gynecology and Pediatrics (Dodds), Dalhousie University, Halifax, NS.
authors.forename: Kimberley
authors.initials: K
authors.lastname: Nix
authors.affiliation: Faculty of Medicine (Nix); Departments of Obstetrics & Gynecology and Pediatrics (Dodds), Dalhousie University, Halifax, NS.
authors.forename: Linda
authors.initials: L
authors.lastname: Dodds