Knowledge of Breastfeeding Recommendations and Breastfeeding Duration: A Survival Analysis on Infant Feeding Practices II

Background: According to the American Academy of Pediatrics, infants should be exclusively breastfed for the first 6 months of life followed by breastfeeding with complementary food for up to 2 years of age or beyond. Knowledge of breastfeeding recommendations may greatly influence breastfeeding practices; however, the association between a woman's knowledge of exclusive breastfeeding recommendations and breastfeeding duration is not well explored. This study aims to examine the relationship between knowledge of exclusive breastfeeding recommendations before birth and breastfeeding duration. Materials and Methods: Data from the prospective, longitudinal 2005-2007 Infant Feeding and Practices Study II were analyzed (N=2,935). Knowledge of national breastfeeding recommendations (yes; no) was based on a survey question asking the recommended length of breastfeeding. Breastfeeding duration was reported in weeks and was analyzed as any breastfeeding or exclusive breastfeeding. Cox proportional hazard models were used to obtain crude and adjusted hazard ratios (HRs) and 95% confidence limits (CLs). Results: Overall, 91.7% of women did not exclusively breastfeed the recommended duration and one in five (21.4%) did not know current breastfeeding recommendations. Women without knowledge of exclusive breastfeeding recommendations had a lower probability of breastfeeding compared with women with knowledge of breastfeeding recommendations. Furthermore, after adjusting for confounders, women without knowledge of exclusive breastfeeding recommendations had 11% higher risk (HR=1.11; 95% CL=1.01-1.23) of ceasing breastfeeding at every point in time compared with women who reported knowledge of breastfeeding recommendations while exclusive breastfeeding was not significant. Conclusions: Findings from this study provide evidence that a mother's knowledge of exclusive breastfeeding recommendations impacts breastfeeding practices. Healthcare providers and public health professionals should educate mothers about breastfeeding.