Barbara commented the other day about the latest issue of JHL, which hasn't
arrived here yet, but I thought I'd add a comment about women's intention to
breastfeed and their intended duration. This is actually more important than
looking at their demographic factors. Susan Donath and I have just published
an article in Acta Paediatrica about this:
Acta Paediatr 2003;92(3):352-6
Relationship between prenatal infant feeding intention and initiation and
duration of breastfeeding: a cohort study.
Donath SM, Amir LH; ALSPAC Study Team.
Turning Point Alcohol and Drug Centre, Melbourne, Australia.
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AIM: To report the relationship between maternal prenatal intention to
breastfeed and the actual initiation and duration of breastfeeding. METHODS:
Pregnant women resident within Avon, UK, expected to give birth between 1
April 1991 and 31 December 1992 were recruited in a longitudinal cohort
study. Main outcome measures included maternal infant feeding intention
(breastfeed, breast and bottle feed, bottle feed, or uncertain) at 32 wk of
pregnancy: intention in the first week, intention for the rest of the first
month and intention in months 2 to 4; initiation and duration of
breastfeeding up to six months. RESULTS: Data were available on 10,548
women. Prenatal intention to breastfeed had an influence on both initiation
and duration of breastfeeding. Of the women intending to bottle feed from
birth, only 3.4% initiated breastfeeding compared with 96.6% of women
planning to breastfeed for at least four months. At six months postpartum,
the mean duration of breastfeeding for women intending to breastfeed for at
least five months was 4.4 mo (95% CI 4.3, 4.4), compared with 2.5 mo (95% CI
2.4, 2.6) for women with a prenatal intention to breastfeed for only one
month. Logistic regression, using intended duration as the only explanatory
variable, correctly predicted 91.4% of breastfeeding initiation and 72.2% of
infant feeding at six months. CONCLUSIONS: This large population-based study
confirms the strength of the relationship between maternal prenatal
intention to breastfeed and both breastfeeding initiation and duration.
Maternal intention was a stronger predictor than the standard demographic
factors combined. This should be taken into account in future research, and
trials should be undertaken to establish whether interventions could alter
maternal intention and thereby increase rates of breastfeeding initiation
and duration.

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