Abstract :
Keywords Breastfeeding; Determinants of breastfeeding; Physiological factors; Social factors; Healthcare professionals' intervention; Breastfeeding promotion Highlights * Factors that affect breastfeeding are not the same in the short and long term. * Smoking and anaemia affect breastfeeding only in its initiation. * Pacifiers and early formula negatively affect breastfeeding at all time points. * Bedsharing positively affects breastfeeding at all time points. * Interventions for promoting breastfeeding should include multiple perspectives. Abstract Background Even if women have intention to breastfeed, they do not always achieve a successful breastfeeding. Aim This study aims to analyse factors affecting breastfeeding prevalence among mothers that intended to breastfeed. Methods This is a prospective observational study involving 401 pregnant women that intended to breastfeed (asked at the 20th week). Breastfeeding prevalence was evaluated in reference to health-related, socio-cultural factors and healthcare professionals' interventions at 1 month, 6 months and 12 months after birth. Data were analysed using descriptive statistical methods, bivariate logistic regression and multivariate logistic regression modelling. Results Independent factors negatively affecting breastfeeding prevalence related to mothers' and newborns' health parameters and birth characteristics included smoking during pregnancy, anaemia and use of analgesia during labour. Regarding sociocultural parameters, being an immigrant, higher education level, intention to breastfeed before pregnancy, comfort with public breastfeeding and bedsharing were positively linked to breastfeeding, while teat or pacifier use in the first week was negatively linked. Regarding healthcare professionals' practices, mother and father/partner antenatal education course attendance and exclusive breastfeeding at the hospital were positively associated with breastfeeding. Conclusion Breastfeeding is a very complex phenomenon affected by multiple and diverse variables. Physiological factors only affect the short term (1st month), while middle and long term BF affecting variables are mainly identical and include mostly socio-cultural factors and also BF related practices, especially in the first days after birth. These data should help to develop more effective breastfeeding promotion strategies. Author Affiliation: (a) Osakidetza, Basque Health Service, La Peña Health Center, Bilbao, Spain (b) Midwifery Teaching Unit, Osakidetza, Basque Health Service, Spain (c) Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain (d) Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain (e) Osakidetza, Basque Health Service, Otxarkoaga Health Center, Bilbao, Spain (f) Osakidetza, Basque Health Service, Basurto University Hospital, Bilbao, Spain (g) Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain * Corresponding author at: Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Bizkaia, Spain. Article History: Received 15 July 2021; Revised 19 November 2021; Accepted 23 November 2021 (footnote)1 Osakidetza, Basque Health Service, Centro de Salud de La Peña, Ibaialde kalea s/n, 48003, Bilbao, Spain. (footnote)2 Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Bizkaia, Spain. (footnote)3 Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Bizkaia, Spain. (footnote)4 Osakidetza, Basque Health Service, Centro de Salud de Otxarkoaga, Zizeruena kalea 1, 48004, Bilbao, Spain. (footnote)5 Osakidetza, Basque Health Service, Basurto University Hospital, Avda. Montevideo 18, 48013 Bilbao, Spain. Byline: Gloria Gutierrez-de-Terán-Moreno [GLORIA.GUTIERREZDETMORENO@osakidetza.eus] (a,b,1), Fátima Ruiz-Litago [fatima.ruiz@ehu.eus] (c,2), Usue Ariz [usue.ariz@ehu.eus] (c,2), Ainhoa Fernández-Atutxa [ainhoa.fernandez@ehu.eus] (d,3), María-Jesús Mulas-Martín [MARIAJESUS.MULASMARTIN@osakidetza.eus] (b,e,4), Estitxu Benito-Fernández [ESTITXU.BENITOFERNANDEZ@osakidetza.eus] (f,5), Begoña Sanz [mariabegona.sanz@ehu.eus] (c,g,*)