IN REVIEW
Variables Associated With Breastfeeding Duration

https://doi.org/10.1111/j.1552-6909.2009.01021.xGet rights and content

ABSTRACT

Objective

To identify the variables associated with breastfeeding duration.

Data Sources

The health science reference databases of CINAHL, PubMed, and the Cochrane Database of Systematic Reviews.

Study Selection

Meta-analyses, Cochrane reviews, literature reviews, and quantitative and qualitative studies published in English from 1998 through 2008.

Data Extraction

Data included all variables, both positive and negative, that were found to influence the outcome of breastfeeding duration.

Data Synthesis

Demographic factors that influence breastfeeding duration are race, age, marital status, education, socioeconomics, and Special Supplemental Nutrition Program for Women, Infants, and Children status. Biological variables consisted of insufficient milk supply, infant health problems, maternal obesity, and the physical challenges of breastfeeding, maternal smoking, parity, and method of delivery. Social variables included paid work, family support, and professional support. Maternal intention, interest, and confidence in breastfeeding were psychological variables.

Conclusion

Human lactation is a complex phenomena and the duration of breastfeeding is influenced by many demographic, physical, social, and psychological variables.

Section snippets

Demographic Variables

Demographic variables that may influence breastfeeding duration are well established and include race, maternal age, marital status, level of education, socioeconomic status, and effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (Table 1).

According to Augstein (1996), race is defined as a local geographic or global human population distinguished as a more or less distinct group by genetically transmitted physical characteristics. There is wide

Biological Variables

Biological variables that may influence breastfeeding duration outcomes include insufficient milk supply, infant health problems, maternal obesity, the physical challenges of breastfeeding, maternal smoking, parity, and vaginal or Cesarean delivery (Table 1). These issues are present in varying degrees among all populations of women.

In an integrative literature review, Wambach et al. (2005) summarized the major findings of research investigations associated with initiation and duration of

Social Variables

Social variables are also important to consider when studying breastfeeding duration, and relate to interactions, attitudes, behaviors, and relationships that occur between people. The social variables in this review included maternal work outside the home, number of working hours per week, breastfeeding support from the significant other, maternal grandmother and close friends, and inconsistent and appropriate support from health care professionals.

Maternal work outside the home is a critical

Psychological Variables

Several psychological variables are associated with breastfeeding duration, including prenatal maternal intention, interest in breastfeeding, and maternal confidence in ability to breastfeed. In their study of psychosocial factors on the duration of breastfeeding, Kronborg and Vaeth (2004) found that positive intent, attitudes, and beliefs all increased breastfeeding duration. In an Australian study to determine the factors associated with breastfeeding at 6 months postpartum, Forster,

Discussion

Breastfeeding initiation rates in America are currently 77%, higher than they have been since the mid-20th century. The United States has met the Healthy People 2010 initiative goal of a 75% breastfeeding initiation rate. Much research has focused on improving this initiation rate with good results. This success, however, should not mask the reality that rising initiation rates have not been accompanied by increased breastfeeding duration. Although every infant benefits from some breastfeeding,

Conclusion

Human lactation is a complex phenomenon influenced by factors that are demographic, biological, social, and psychological. Identifying variables associated with breastfeeding duration provides information and references for nurses and others interested in prolonging breastfeeding experiences for women and their infants. Recognizing these variables can guide the interventions that are provided by nurses and health care workers. This information may also be used to generate studies that focus on

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