Factors determining exclusive breastfeeding by multiparas in the first month after delivery

Abstract

Objectives: This study sought to clarify various factors related to past and current experience of breastfeeding in regard to exclusive breastfeeding by multiparas who have breastfed in the first month after delivery, and to ascertain the level of impact those factors had on exclusive breastfeeding. This study also sought to elucidate the factors determining exclusive breastfeeding. Subjects and methods: Of 20 facilities asked to participate in this study, 16 consented. In these facilities, a survey was conducted to multiparas 1 to 2 months after a full-term singleton delivery. Subjects were 635 mothers who had no serious complications after delivery and who began breastfeeding while in the hospital. A questionnaire was devised by identifying factors associated with choosing breastfeeding and with continuing to breastfeed based on previous studies and a review of the literature. Questions and phrasing were re-examined by 6 researchers in related fields and midwives in order to improve content validity. To ascertain the time that was required to answer the questionnaire and to assess face validity, a pre-test was given to 10 multiparas and the above-mentioned 6 specialists to finalize the questionnaire. Results: Five hundred and one responses (response rate: 78.9%) were collected. Of them, 485 responses (valid response rate: 76.4%) were analyzed. Preliminary analysis revealed factors influencing exclusive breastfeeding. These factors were adjusted as covariates when logistic regression analysis was performed. Results indicated that several factors were significantly associated: choosing in the 36th of pregnancy to breastfeed exclusively after delivery, not feeling as if one did not have enough milk [to breastfeed], not using a baby bottle or pacifier, having an older sibling who was exclusively breastfed, and having an older sibling who was breastfed prior to a medical checkup at 1 month of age. Conclusion: The factor that had the greatest impact on exclusive breastfeeding by multiparas in the first month after delivery was choosing in the 36th of pregnancy to breastfeed exclusively. Results suggested that multiparas who had breastfed need support so that in advance of delivery they can 'choose to breastfeed exclusively' and firmly decide to raise their current child on breast milk.