Factors affecting intention to breastfeed of a group of Brazilian childbearing women

Abstract

Background

Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates.

Aim

The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Araçatuba, Brazil.

Methods

The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to women’s age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%.

Findings

Participants mean age was 26.1 ± 5.9 years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p = 0.001), previous breastfeeding experience (p = 0.03), and previous breastfeeding guidance (p = 0.01). Intended breastfeeding duration was significantly affected by women’s age (p = 0.04), employment (0.02), the number of gestations (p = 0.001), and previous breastfeeding experience (p = 0.04).

Conclusions

Previous positive breastfeeding experience and guidance during prenatal examinations positively affected women’s intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time.

Introduction

Breast milk provides babies the best possible nutrition and protection against infection during the first months of life and has a fundamental role in their development.1, 2, 3 The act of breastfeeding (BF) brings unquestionable benefits to both the general and oral health of the baby throughout life.1, 2, 3, 4, 5, 6 According to the latest UNICEF update (2015), the prevalence of exclusive breastfeeding in Brazil up to six months of age is 39%.⁷ Data from the Brazilian Ministry of Health indicate that mean BF duration increased from 296 to 342 days, while exclusive BF raised from 23.4 to 54.1 days in the period between 1999–2008.8, [9] Despite the improvements observed in the last few years, BF rates still fall short from those recommended by national and international organizations, that is, exclusive breastfeeding until the baby is at least six months old, to be followed in complemented form up to two years or more.1, 2, 3 Although considered natural and instinctive, BF can be affected by numerous biological, social, historical and cultural factors.10, 11, 12 According to Scavenius et al.¹² social constraints in relation to BF may develop, leading to decreased suckling and eventually to the cessation of BF.

The intention to breastfeed expressed by mothers during pregnancy is considered one of the strongest predictors of the initiation and duration of breastfeeding.13, 14, 15, 16, 17, 18, 19 The stronger the intention to breastfeed during the prenatal period, the more likely the mother will exclusively breastfeed after the baby is born.¹⁶ Previous studies showed that the intention reported by childbearing women in Brazil to breastfeed their babies is extremely high.18, 19 In a study conducted by Issler et al.¹⁸ 98.5% of women studied reported the intention to breastfeed, while in a more recent study by Machado et al.¹⁹ this prevalence was even higher (100%).

In a country of continental size such as Brazil, with large social, ethnic and cultural differences, the challenges for the development of health in the population in general are enormous. Studies have shown that many women are reluctant to seek dental care during the pregnancy period, except in situations of emergency. The reasons for this behavior are rooted in cultural beliefs that dentistry is merely curative, as well as the fears and anxieties related to dental treatment.20, 21 Thus, public programs dedicated to change this scenario and highlight the importance of oral care for both mothers and their babies can have a positive impact on their health.²²

In line with this perception, a public dental school in the city of Araçatuba (Brazil) has established a dental care program specifically designed for childbearing women.²² Local childbearing women who are cared for by the public health system are invited to participate in the program, where in addition to receiving oral care, they also receive information on the importance of breastfeeding on the oral health of their children. Women interested in participating in the program are closely followed by dental students and college professors, and detailed information are collected. The investigation of this particular group of women has the potential to bring to light some important evidence about the intention to breastfeed, which, in turn, could help in action planning to improve BF rates in the general population.

Thus, the objective of this study was to verify the intention to breastfeed and the intended BF duration of a group of women participating in a public prenatal dental care program in relation to the different variables that may affect this decision.