A Post Hoc Analysis of Demographic, Socioeconomic, Health and Mental Health Factors Following a Lactation-Consultant-Led Telephone Breastfeeding Support Program.

BACKGROUND/

OBJECTIVES

Breast Milk Feeding (BMF) benefits mother and infant. However, women with select risk factors report shorter breastfeeding durations. Our previous prospective cohort observational study of a lactation-consultant-led telephone-based support program in the first month postpartum increased BMF rates up to 6 months. This post hoc study further evaluated the program for mothers at increased risk of early breastfeeding cessation.

METHODS

We performed secondary analysis involving 762 mothers (control, n = 378; intervention, n = 384), recruited between 2018 and 2019. Infant feeding types, including BMF, were recorded at 1, 3 and 6 months. Feeding outcomes were analyzed in association with maternal risk factors. p-values, odds ratios and 95% confidence intervals were reported via both univariate (UVA) and multivariate regression analysis (MVA).

RESULTS

Via MVA, the intervention was associated with increased 6-month BMF rates in these groupings [OR (95%CI), p-value]: European [1.80 (1.07-2.96), p = 0.027]; South Asian [1.93 (1.19-3.13), p = 0.008]; employed [1.47 (1.02-2.12), p = 0.038]; unemployed [2.15 (1.33-3.50), p = 0.002]; married [1.71 (1.22-2.39), p = 0.002]; social support present [1.51 (1.05-2.16), p = 0.026]; chronic illness [1.93 (1.35-2.75), p = 0.001]; gestational diabetes mellitus [2.17 (1.19-3.95), p = 0.11]; overweight and obese [1.48 (1.03-2.12), p = 0.034]. A derived success score across the study period indicated via UVA associated increases in BMF rates with history of depression and anxiety (MI) [p = 0.044] and ongoing MI [p = 0.033], but these increases were smaller than that for no history of MI [p < 0.001]. No effect was observed in East/Southeast Asian mothers, Middle Eastern mothers, single or de facto mothers, older mothers, mothers without social support and mothers of any skill level.

CONCLUSIONS

Although early postpartum telephone support was associated with a number of positive findings of improved BMF at 6 months and over the course of the study, the results were mixed. This suggests that future breastfeeding telephone-based initiatives need to be multifaceted in order to target mothers at risk of early breastfeeding cessation.