BREAST-FEEDING IN ISRAEL - MATERNAL FACTORS ASSOCIATED WITH CHOICE AND DURATION

Study objectives - To determine the influence of maternal characterist ics on the incidence and duration of breast feeding. Design - All the women who delivered in three obstetric wards within a two year period were surveyed. These three wards cover 93% of all births in the Jerusa lem district. Women were interviewed on breast feeding of the previous child on the first or second day post partum by a research nurse. Par ticipants - Altogether 8486 women whose previous pregnancy had resulte d in a live born singleton who survived for at least one year. Measure ments and main results - Breast feeding information was linked to demo graphic and health information from hospital records. Using logistic r egression analysis, failure to start breast feeding was best predicted (p < 0.001) by caesarean delivery, infant's birth weight, maternal sm oking habits, and mother being non-immigrant. Maternal age (< 24 or > 40 years) and father being an ultraorthodox Jew were also positively ( p < 0.05) associated with the decision to breast feed. Long term breas t feeding (three months or more) was strongly affected (p < 0.001) by maternal education level. with both women with the fewest and the grea test number of years of schooling more likely to breast feed. A simila r association was observed in all ethnic groups. Primipara and grandmu ltipara (parity > 4), new immigrants, ultraorthodox Jews, and non-smok ers breast fed their babies for longer. Conclusions - The importance o f maternal characteristics in relation to breast feeding was shown. Ca esarian delivery and the infant's birth weight were strongly related t o the decision to breast feed as were the demographic characteristics of mother's age and her country of birth. Education was not related to this decision but was strongly associated with the duration of breast feeding, as was parity. The behavioural characteristics of smoking an d being ultraorthodox were related to both the decision to start and t he duration of breast feeding. Efforts to encourage breast feeding oug ht to be targeted during the hospital stay and post partum period towa rds women identified as being at increased risk.