Predictors of Breastfeeding Initiation and Maintenance in an Integrated Healthcare Setting

Background:The American Academy of Pediatrics recommends exclusive breastfeeding to age 6 months. Although breastfeeding rates in the United States have been increasing over time, further improvements are needed to meet Healthy People 2020 targets.Research aim:This study examined predictors of breastfeeding initiation and maintenance among a population of insured pregnant women.Methods:Participants were 1,149 pregnant women enrolled in the Pregnancy and Influenza Project in two Kaiser Permanente regions in 2010-2011. Data were collected through interviews at enrollment and 1 month and 6 months postpartum and through participants’ electronic medical records.Results:Nearly all (99%) women reported initiating breastfeeding. Rates of exclusive breastfeeding were 70% and 54% at 1 month and 6 months, respectively; an additional 22% and 23% of women reported supplementing breastfeeding with formula. Of the women who supplemented, the mean (SD) infant age at formula introduction was 53 (62) days. Of those who had...