The timing and predictors of the early termination of breastfeeding

Objective. To determine the prevalence and correlates of the early disconti nuation of breastfeeding by mothers eligible for the Women, Infants, and Ch ildren Program (WIC). Methodology. A longitudinal observational study in which we enrolled Englis h-speaking mothers who initiated breastfeeding after delivering healthy-ter m infants at Yale-New Haven Hospital and planned to bring their infants to the hospital's primary care center. Data on mother's baseline knowledge, at titudes, beliefs, and problems regarding breastfeeding were collected by se mistructured interviews within 48 hours after delivery, at 1 and 2 weeks' p ostpartum, and by chart reviews at 2 and 4 months. A nonparticipating contr ol group was used to test the Hawthorne effect. Results. Of the 64 participating mothers, the majority were minority (56% b lack, 34% of Puerto Rican origin), single (75%), and already enrolled in WI C (91%). The rates of discontinuation of breastfeeding were 27%, 37%, 70%, and 89% by 1 week, 2 weeks, 2 months, and 4 months, respectively. The mothe r's knowledge and problems of lactation were not associated with the early discontinuation of breastfeeding. After using logistic regression to contro l for potential confounders, mothers who lacked confidence at baseline that they would still be breastfeeding at 2 months (risk ratio: 2.38, 95% confi dence interval: 1.82-6.18), and those who believed that the baby prefers fo rmula (risk ratio: 1.68, 95% confidence interval: 1.04-2.71) were more like ly to stop breastfeeding within the first 2 weeks postpartum. Conclusions. The results of this study demonstrate that interventions aimed at prolonging the duration of breastfeeding in this population will need t o shift focus from increasing knowledge and managing problems of lactation to enhancing the mother's confidence regarding breastfeeding, while also ad dressing beliefs regarding an infant's preferences.