Determinants of breast-feeding in a Finnish birth cohort

OBJECTIVE: To assess milk feeding on the maternity ward and during infancy, and their relationship to sociodemographic determinants. The validity of our 3-month questionnaire in measuring hospital feeding was assessed. DESIGN: A prospective Finnish birth cohort with increased risk to type 1 diabetes recruited between 1996 and 2004. The families completed a follow-up form on the 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 main study, and 117 randomly selected infants in the validation study. RESULTS: Breast milk was the predominant milk on the maternity ward given to 99 % of the infants. Altogether, 80 % of the women recalled their child being fed supplementary milk (donated breast milk or infant formula) on the maternity ward. The median duration of exclusive breast-feeding was 1.4 months (range 0-8) and that of total breast-feeding 7.0 months (0-25). Additional milk feeding on the maternity ward, short parental education, maternal smoking during pregnancy, small gestational age and having no siblings were associated with a risk of short duration of both exclusive and total breast-feeding. In the validation study, 78 % of the milk types given on the maternity ward fell into the same category, according to the questionnaire and hospital records. CONCLUSIONS: The recommendations for infant feeding were not achieved. Infant feeding is strongly influenced by sociodemographic determinants and feeding practices on the maternity wards. Long-term breast-feeding may be supported by active promotion on the maternity ward.