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. 2021 Mar 18;11(3):e041625.
doi: 10.1136/bmjopen-2020-041625.

Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study

Iván Dueñas-Espín  1 , Ángela León Cáceres  2   3 , Angelica Álava  4 , Juan Ayala  5 , Karina Figueroa  6 , Vanesa Loor  7 , Wilmer Loor  8 , Mónica Menéndez  9 , David Menéndez  10 , Eddy Moreira  11 , René Segovia  12 , Johanna Vinces  13
Affiliations

Breastfeeding education, early skin-to-skin contact and other strong determinants of exclusive breastfeeding in an urban population: a prospective study

Iván Dueñas-Espín et al. BMJ Open. .

Abstract

Objective: The current study aims to demonstrate independent associations between social, educational and health practice interventions as determinants of exclusive breastfeeding in an urban Ecuadorian population.

Design: Prospective survival analyses.

Setting: Ecuadorian mother-child dyads in urban settings.

Participants: We followed-up 363 mother-baby dyads who attended healthcare centres in Portoviejo, province of Manabi, for a median time (P25-P75) of 125 days (121-130 days).

Main outcome measures: We performed a survival analysis, by setting the time-to-abandonment of exclusive breastfeeding measured in days of life, that is, duration of exclusive breastfeeding, periodically assessed by phone, as the primary outcome. Crude and adjusted mixed-effects Cox proportional hazards model were performed to estimate HRs for each explanatory variable.

Results: The incidence rate of abandonment of breastfeeding was 8.9 per 1000 person-days in the whole sample. Multivariate analysis indicated the three most significant protective determinants of exclusive breastfeeding were (a) sessions of prenatal breastfeeding education with an HR of 0.7 (95% CI: 0.5 to 0.9) per each extra session, (b) self-perception of milk production, with an HR of 0.4 (95% CI: 0.3 to 0.6) per each increase in the perceived quantity of milk production and (c) receiving early skin-to-skin contact with an HR of 0.1 (95% CI: <0.1 to 0.3) compared with those not receiving such contact, immediately after birth.

Conclusions: Prenatal education on breastfeeding, self-perception of sufficient breast-milk production and early skin-to-skin contact appear to be strong protectors of exclusive breastfeeding among urban Ecuadorian mother-baby dyads.

Keywords: epidemiology; general medicine (see internal medicine); preventive medicine; public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Kaplan-Meier survival estimates of duration of exclusive breastfeeding by early skin-to-skin contact categories.
See this image and copyright information in PMC

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