Prospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Aug 8, 2016; 5(3): 349-357
Published online Aug 8, 2016. doi: 10.5409/wjcp.v5.i3.349
Factors affecting breastfeeding duration in Greece: What is important?
Evangelia-Filothei Tavoulari, Vassiliki Benetou, Petros V Vlastarakos, Theodora Psaltopoulou, George Chrousos, George Kreatsas, Alexandros Gryparis, Athena Linos
Evangelia-Filothei Tavoulari, Vassiliki Benetou, Theodora Psaltopoulou, Alexandros Gryparis, Athena Linos, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, 11527 Goudi, Athens, Greece
Petros V Vlastarakos, ENT Department, MITERA Paediatric Infirmary, 15123 Marousi, Athens, Greece
George Chrousos, 1st Department of Pediatrics, University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
George Kreatsas, 2nd OBG Department, Aretaieion University Hospital, 11528 Athens, Greece
Author contributions: Tavoulari EF conducted the research, participated in the interpretation of data, and wrote the article; Benetou V participated in study design and in the interpretation of data, and wrote the article; Vlastarakos PV participated in the interpretation of data, and wrote the article; Psaltopoulou T participated in the interpretation of data, and critically reviewed the article; Chrousos G and Linos A participated in study design and critically reviewed the article; Kreatsas G provided the setting and patients for the study, participated in study design, and critically reviewed the article; Gryparis A prepared the statistical analysis of data, and critically reviewed the article; all authors read and approved the final manuscript.
Institutional review board statement: The study protocol was approved by the Ethics Committee of the Medical School of the University of Athens.
Clinical trial registration statement: None.
Informed consent statement: All participants were asked to sign an informed consent form before being enrolled in the study.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose. The authors have no financial interests, and have not received any financial support for this article.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Evangelia-Filothei Tavoulari, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, 75 Mikras Asias Str., 11527 Goudi, Athens, Greece. tavoularieva@yahoo.gr
Telephone: +30-210-8577976
Received: February 1, 2016
Peer-review started: February 1, 2016
First decision: March 21, 2016
Revised: May 10, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 8, 2016
Abstract

AIM: To investigate factors associated with breastfeeding duration (BD) in a sample of mothers living in Greece.

METHODS: Four hundred and twenty-eight mothers (438 infants) were initially recruited in a tertiary University Hospital. Monthly telephone interviews (1665 in total) using a structured questionnaire (one for each infant) were conducted until the sixth postpartum month. Cox regression analysis was used to assess factors influencing any BD.

RESULTS: Any breastfeeding rates in the first, third, and sixth month of the infant’s life reached 87.5%, 57.0% and 38.75%, respectively. In the multivariate analysis, maternal smoking in the lactation period [hazard-ratio (HR) = 4.20] and psychological status (HR = 1.72), and the introduction of a pacifier (HR = 2.08), were inversely associated, while higher maternal education (HRuniversity/collegevsprimary/high school = 0.53, HRmaster’svsprimary/high school = 0.20), and being an immigrant (HR = 0.35) were positively associated with BD.

CONCLUSION: Public health interventions should focus on campaigns against smoking during lactation, target women of lower educational status, and endorse the delayed introduction of pacifiers.

Keywords: Breastfeeding, Exclusive, Formula feeding, Duration, Greece

Core tip: This was a prospective study investigating the factors which are associated with breastfeeding duration (BD) in a sample of mothers living in Greece. Maternal smoking during lactation, the respective psychological status, and the introduction of a pacifier, were inversely associated, while higher maternal education and maternal immigrant status positively associated with BD. Public health interventions should focus on campaigns against smoking during lactation, target women of lower educational status, and endorse the delayed introduction of pacifiers.