Determinants of breast-feeding in a Finnish birth cohort

Department of Paediatrics and Research Unit, Tampere University Hospital, Tampere, FinlandSubmitted 5 March 2009: Accepted 8 September 2009: First published online 13 October 2009AbstractObjective: To assess milk feeding on the maternity ward and during infancy, andtheir relationship to sociodemographic determinants. The validity of our 3-monthquestionnaire in measuring hospital feeding was assessed.Design: A prospective Finnish birth cohort with increased risk to type 1 diabetesrecruited between 1996 and 2004. The families completed a follow-up form onthe age at introduction of new foods and age-specific dietary questionnaires.Setting: Type 1 Diabetes Prediction and Prevention (DIPP) project, Finland.Subjects: A cohort of 5993 children (77% of those invited) participated in the mainstudy, and 117 randomly selected infants in the validation study.Results: Breast milk was the predominant milk on the maternity ward given to99% of the infants. Altogether, 80% of the women recalled their child being fedsupplementary milk (donated breast milk or infant formula) on the maternityward. The median duration of exclusive breast-feeding was 1?4 months (range0–8) and that of total breast-feeding 7?0 months (0–25). Additional milk feedingon the maternity ward, short parental education, maternal smoking duringpregnancy, small gestational age and having no siblings were associated with arisk of short duration of both exclusive and total breast-feeding. In the validationstudy, 78% of the milk types given on the maternity ward fell into the samecategory, according to the questionnaire and hospital records.Conclusions: The recommendations for infant feeding were not achieved. Infantfeeding is strongly influenced by sociodemographic determinants and feedingpractices on the maternity wards. Long-term breast-feeding may be supported byactive promotion on the maternity ward.KeywordsBreast-feedingInfant feedingMaternity wardCow’s milkSociodemographic determinantsDietary assessment methodAs a global public health recommendation of the WHO