The relationship between vulnerability factors and breastfeeding outcome

Abstract

Objectives. To determine whether vulnerability factors (confidence with breastfeeding, postpartum depression, supplementation and perceived adequacy of support) explain breastfeeding outcome at six weeks postpartum after controlling for age and education. To describe the use of breastfeeding resources by women with vulnerability factors. Design. Cross-sectional telephone survey at six weeks postpartum. Setting. Ottawa-Carleton, Ontario, Canada. Participants. A proportionate, consecutive sample of breastfeeding women from each of four hospitals in the region was conducted (n = 526/554, 95% response rate). Methods. Secondary analyses of data, using stratified bivariate analyses to examine the relationship between each factor and breastfeeding outcome. Multivariate logistic regression analyses examined relationships between all factors and breastfeeding outcome. Missing data was 7.0%. Results. For breastfeeding mothers (n = 526), while confidence, postpartum depression and supplementation were significantly related to breastfeeding in the bivariate analyses, only confidence with breastfeeding (OR: 1.85, 95% CI: 1.50, 2.27, p < 0.001) and postpartum depression (OR: 0.28, 95% CI: 0.11, 0.71, p = 0.007) were independently related to breastfeeding in the logistic regression analyses. Approximately half of the women (n = 262, 49.8%) did not access any community resources. Conclusions. Assessment of maternal confidence with breastfeeding and postpartum depression need to be conducted. Intervention strategies to address these vulnerability factors need to be evaluated. Supplementation policies of infants in hospital need review. A cost-effectiveness analysis of the use of community resources is recommended.