Abstract :
Keywords Breastfeeding; Formula feeding; Negative life experiences; The life experience survey (LES); Weaning Highlights * Of the various barriers to breastfeeding, limited information is available on the stressful life events in pregnancy. * Negative life events in pregnancy were at greater risk for formula adoption. * Identification of negative life events may help provide anticipatory guidance to improve breastfeeding. Abstract Objective The aim of this study was to examine the association between prenatal stressful life events in pregnancy and breastfeeding initiation, exclusivity, and duration, defined according to the WHO. Study design Feeding practices were prospectively collected from 425 puerperae living in an industrialized area of Northeast Italy starting on the second day post-partum, when they filled out the Life Experience Survey (LES, 1978). Results In this sample, analysis revealed that at discharge 65/358 (18.16 %) puerperae presented with a negative LES score and 293/358 (81.84 %) with a positive LES score. Puerperae with negative LES scores were more likely to adopt formula at discharge, either to complement breast milk or to substitute breast milk altogether (16/65; 24.62 % vs 43/293; 14.68 %; RR = 1.64 and 95 % CI: 1.01--2.70), and they were also more likely to adopt exclusive formula feeding at the 3rd month of life (8/48; 16.66 % versus 18/242; 7.44 %; RR = 2.03 and 95%CI: 1.06--3.86). At the 6th month of life, there were significantly less puerperae with a negative LES score who were breastfeeding exclusively (1/48; 2.08 vs 44/249; 17.67 %; RR = 0.11 and 95 % CI: 0.01--0.84) and correspondingly there were significantly more puerperae with a negative LES score who were using formula feeding with weaning practices (20/48; 41.67 % vs 35/249; 14.06 %; RR =3.14 and 95 % CI: 1.82--5.04). Conclusions Identification of specific barriers to breastfeeding related to negative life events in pregnancy may help direct providers' anticipatory guidance to improve breastfeeding rates in high-risk populations. Author Affiliation: (a) Division of Perinatal Medicine, Policlinic Abano Terme, Abano Terme, Italy (b) UC San Diego School of Medicine, California, USA (c) Cavalese Hospital, Cavalese, Italy * Corresponding author at: Division of Perinatal Medicine, Policlinico Abano Terme, Piazza Colombo 1, 35031 Abano Terme, Italy. Article History: Received 22 January 2022; Revised 7 June 2022; Accepted 9 June 2022 Byline: Zanardo Vincenzo [vincenzo.zanardo@libero.it] (a,*), Sandri Andrea (b), Giustardi Arturo (c), Straface Gianluca (a)