Research on determinants of breastfeeding duration: Suggestions for biocultural studies

The main purpose of this paper is to suggest directions for future intra-cultural research on the factors that affect breastfeeding duration, especially policy-oriented research. A 2nd purpose is to call for a reexamination of the theoretical construct, biocultural determinants, with respect to infant feeding. The study compares determinants in 4 multivariate studies. One was carried out in Connecticut, 1 in a working class community in Scotland, another in England and the 4th in Sweden. Almost no biological factors are strongly associated with breastfeeding duration in any of the population studied. Of the external factors, those relating to social support and advice were the most consistent predictors. Socioeconomic status, income, and work outside the home were not good predictors. Maternal attitudes and experience are of great importance in predicting feeding duration. The general picture that emerged from all the studies is that if a mother wants to breastfeed, she can. Mothers breastfeed longer if they desire to breastfeed; they intend to do it for a longer period of time; they feel comfortable feeding in public; they are informed about breastfeeding; and they are not anxious about the process. There is also fairly strong evidence linking a number of biocultural factors to feeding duration. Whether the linkage is biological or behavioral has significant policy implications: if it is biological, successful intervention would require a change in hospital practices to earlier 1st feeding; if the linkage is behavioral, the problem might be resolved through improved maternal education.