Intention to breastfeed among pregnant women: association with work, smoking, and previous breastfeeding experience

Fernandes, Renata Cordeiro; Höfelmann, Doroteia Aparecida

doi:10.1590/1413-81232020253.27922017

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FREE THEMES • Ciênc. saúde coletiva 25 (3) • Mar 2020 • https://doi.org/10.1590/1413-81232020253.27922017 copy

Intention to breastfeed among pregnant women: association with work, smoking, and previous breastfeeding experience

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective of this study was to estimate the prevalence of intention to breastfeed (IB) for an insufficient (under 6 months) or prolonged (24 months and longer) amount of time and to investigate its association with demographic and socioeconomic status, health behaviors, obstetric history, and previous breastfeeding experience among pregnant women. This is a cross-sectional study made with pregnant women under prenatal care in 17 units of the Family Health Strategy, in Colombo (PR). Crude and adjusted multinomial logistic regression analyses were used to identify associations between IB and exposure variables. Among pregnant women participating in the survey (n = 316), 99.1% reported IB. The average IB time was 13.5 months. The IB for insufficient and prolonged time was referred to by 9.8% and 22.0% of participants respectively. Those who presented the greatest changes of IB for insufficient time were women who: did not have a partner (OR 3.23, 95% CI 1.31; 7.94), who performed paid work (OR 5.56, 95% CI 2.10; 14.71), and smokers (OR 7.79, 95% CI 2.35; 25.81). Prolonged IB was more frequent among pregnant women with previous experience in prolonged breastfeeding (OR 3.05, 95% CI 1.02; 9.03). Factors associated to IA were found to support actions directed to vulnerable groups aiming the promotion of breastfeeding practices.

Key words
Intention; Breastfeeding; Pregnancy

Variables	n (%)
Demographic
Age (in years) (n = 286)
Up to 20	40 (14.0)
20-34	217 (75.9)
≥35	29 (10.1)
Live with their partner (n = 286)
No	46 (16.1)
Yes	240 (83.9)
Socioeconomic
Schooling (in years) (n = 286)
Up to 7	67 (23.4)
8-10	112 (39.2)
≥11	107 (37.4)
Paid work (n = 286)
No	164 (57.3)
Yes	122 (42.7)
Health Behavior
Smoking (n = 285)
No	257 (90.2)
Yes	28 (9.8)
Obstetric History
Number of pregnancies (n = 286)
1	86 (30.1)
2	105 (36.7)
≥ 3	95 (33.2)
Breastfeeding time in the first pregnancy (in months) (n = 164)
< 6	46 (28.1)
6 - 23	85 (51.8)
≥ 24	33 (20.1)
Outcome
Intention to breastfeed (time/months) (n = 286)
< 6	28 (9.8)
6 - 23	195 (68.2)
≥ 24	63 (22.0)

Variables	Fewer than 6 months	6 to 23 months	24 months or more
Variables	n(%)	n(%)	n(%)	P-value*
Demographic
Age (in years) (n = 286)				0.300
Up to 20	4 (10.0)	32 (80.0)	4 (10.0)
20-34	21 (9.7)	142 (65.4)	54 (24.9)
≥ 35	3 (10.3)	21 (72.4)	5 (17.2)
Live with their partner (n = 286)				0.026
No	9 (19.6)	25 (54.3)	12 (26.1)
Yes	19 (7.9)	170 (70.8)	51 (21.3)
Socioeconomic
Schooling (in years) (n = 286)				0.248
Up to 7	9 (13.4)	40 (59.7)	18 (26.9)
8-10	11 (9.8)	74 (66.1)	27 (24.1)
≥ 11	8 (7.5)	81 (75.7)	18 (16.8)
Paid work (n = 286)				0.001
No	7 (4.3)	114 (69.5)	43 (26.2)
Yes	21 (17.2)	81 (66.4)	20 (16.4)
Health Behavior
Smoking (n = 285)				0.002
No	20 (7.8)	179 (69.6)	58 (22.6)
Yes	8 (28.6)	16 (57.1)	4 (14.3)
Obstetric History
Number of pregnancies (n = 286)				0.162
1	4 (4.7)	66 (76.7)	16 (18.6)
2	11 (10.5)	71 (67.6)	23 (21.9)
≥ 3	13 (13.7)	58 (61.0)	24 (25.3)
Breastfeeding time in the first pregnancy (in months) (n = 149)				0.001
< 6	10 (24.4)	26 (63.4)	5 (12.2)
> 6 - 23	4 (5.2)	59 (76.6)	14 (18.2)
≥ 24	4 (12.9)	10 (32.3)	17 (54.8)

Variables	Fewer than 6 months vs 6 to 23 months		24 or more months vs 6 to 23 months
Variables	OR (95% CI)	Adjusted OR (95% CI)	OR (95% CI)	Adjusted OR (95% CI)
Demographic
Age (in years) (n = 286)
Up to 20	1	1	1	1
20 - 34	1.18 (0.37; 3.68)	1.19 (0.38; 3.75)	3.04 (1.02; 9.00)	3.05 (1.02; 9.03)
≥ 35	1,14 (0,23; 5,63)	1.06 (0.21; 5.35)	1.90 (0.45; 7.92)	1.86 (0.44; 7.75)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.834	0.896^a	0.309	0.328^a
Live with their partner (n = 286)
Yes	1	1	1	1
No	3.22 (1.31; 7.90)	3.23 (1.31; 7.94)	1.60 (0.75; 3.40)	1.62 (0.75; 3.49)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.011	0.011^a	0.223	0.237^a
Socioeconomic
Schooling (in years) (n = 286)
Up to 7	1	1	1	1
8 - 10	0.66 (0.25; 1.72)	0.64 in (0.23; 1.80)	0.81 (0.40; 1.64)	0.89 (0.43; 1.85)
≥ 11	0.43 (0.16; 1.22)	0.29 (0.09; 0.86)	0.50 (0.23; 1.05)	0.50 (0.23; 1.10)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.113	0.023^b	0.059	0.074^b
Paid work (n = 286)
No	1	1	1	1
Yes	4.22 (1.71; 10.40)	5.56 (2.10; 14.71)	0.65 (0.36; 1.19)	0.66 (0.35; 1.24)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.002	0.001^b	0.168	0.253^b
Health Behavior
Smoking (n = 285)
No	1	1	1	1
Yes	4.4 (1.70; 11.76)	7.79 (2.35; 25.81)	0.77 (0.25; 2.40)	0.54 (0.16; 1.75)
P-value	0.002	0.001	0.654	0.301
Obstetric History
Number of pregnancies (n = 285)
1	1	1	1	1
2	2.56 (0.77; 8.42)	2.71 (0.77; 9.57)	1.34 (0.65; 2.75)	1.25 (0.59; 2.63)
≥ 3	3.70 (1.14; 11.97)	3.44 (0.86; 13.75)	1.70 (0.83; 3.52)	1.22 (0.54; 2.79)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.027	0.122^d	0.145	0.556^d
Breastfeeding time in the first pregnancy (in months) (n = 164)
< 6	1	1	1	1
6 - 23	0.18 (0.50; 0.61)	0.08 (0.02; 0.39)	1.23 (0.40; 3.78)	1.14 (0.36; 3.66)
≥ 24	1.04 (0.30; 4.09)	0.46 (0.08; 2.68)	8.84 (2.57; 30.40)	7.32 (1.99; 26.90)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.333	0.080^e	<0.001	0.003^e
Health Behavior
Smoking (n = 285)
No	1	1	1	1
Yes	4.40 (1.70; 11.76)	7.79 (2.35; 25.81)	0.77 (0.25; 2.40)	0.54 (0.16; 1.75)
P-value	0.002	0.001	0.654	0.301
Obstetric History
Number of pregnancies (n = 285)
1	1	1	1	1
2	2.56 (0.77; 8.42)	2.71 (0.77; 9.57)	1.34 (0.65; 2.75)	1.25 (0.59; 2.63)
≥ 3	3.70 (1.14; 11.97)	3.44 (0.86; 13.75)	1.70 (0.83; 3.52)	1.22 (0.54; 2.79)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.027	0.122^d	0.145	0.556^d
Breastfeeding Experience
Breastfeeding time in the first pregnancy (in months) (n = 164)
<6	1	1	1	1
6 - 23	0.18 (0.50; 0.61)	0.08 (0.02; 0.39)	1.23 (0.40; 3.78)	1.14 (0.36; 3.66)
≥ 24	1.04 (0.30; 4.09)	0.46 (0.08; 2.68)	8.84 (2.57; 30.40)	7.32 (1.99; 26.90)
P-value^* * Wald Test for Multinomial Logistic Regression. Adjusted by levels: a) Demographic; b) Demographic and Socioeconomic; (c) Demographic, Socioeconomic, and Smoking; (d) Demographic, Socioeconomic, Smoking, and Obstetric History; e) Demographic, Socioeconomic, Smoking, Obstetric History, and Breastfeeding Experience.	0.333	0.080^e	<0.001	0.003^e

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[1] Collaborations

RC Fernandes and DA Höfelmann participated in the research planning, analysis and interpretation of data, writing of the article, and approval of the final version of the article.