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Premature cessation of breastfeeding in infants: development and evaluation of a predictive model in two Argentinian cohorts: the CLACYD study *, 1993–1999
Author(s) -
Berra S,
Rajmil L,
Passamonte R,
Fernandez E,
Sabulsky J
Publication year - 2001
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2001.tb00796.x
Subject(s) - medicine , breastfeeding , logistic regression , confidence interval , odds ratio , pediatrics , obstetrics , demography , birth order , childbirth , breast feeding , receiver operating characteristic , pregnancy , population , environmental health , pathology , sociology , biology , genetics
The objective of this study was to develop a model to predict premature cessation of breastfeeding of newborns, in order to detect at‐risk groups that would benefit from special assistance programmes. The model was constructed using 700 children with a birthweight of 2000 g or more, in 2 representative cohorts in 1993 and 1995 (CLACYD I sample) in Córdoba, Argentina. Data were analysed from 632 of the cases. Mothers were selected during hospital admittance for childbirth and interviewed in their homes at 1 mo and 6 mo. To evaluate the model, an additional sample with similar characteristics was drawn during 1998 (CLACYD II sample). A questionnaire was administered to 347 mothers during the first 24–48 h after birth and a follow‐up was completed at 6 mo, with weaning information on 291 cases. Premature cessation of breastfeeding was considered when it occurred prior to 6 mo. A logistic regression model was fitted to predict premature end of breastfeeding, and was applied to the CLACYD II sample. The calibration (Hosmer‐Lemeshow C statistic) and the discrimination [area under the receiver operating characteristics (ROC) curve] of the model were evaluated. The predictive factors of premature end of breastfeeding were: mother breastfed for less than 6 mo [odds ratio (OR) = 1.84,95% confidence interval (CI) 1.26–2.70], breastfeeding of previous child for less than 6 mo (OR = 4.01, 95% CI 2.58–6.20), the condition of the firstborn child (OR = 2.75, 95% CI 1.79–4.21), the first mother‐child contact occurring after 90min of life (OR =1.88; 95% CI 1.22–2.91) and having an unplanned pregnancy (OR = 1.50, 95% CI 1.05–2.15). The calibration of the model was acceptable in the CLACYD I sample ( p = 0.54), as well as in the CLACYD II sample ( p = 0.18). The areas under the ROC curve were 0.72 and 0.68, respectively. Conclusion: A model has been suggested that provides some insight onto background factors for the premature end of breastfeeding. Although some limitations prevent its general use at a population level, it may be a useful tool in the identification of women with a high probability of early weaning.