Factors associated with exclusive breastfeeding at 6 weeks postpartum in Southwest China: a cross-sectional study

Abstract

Breastfeeding is known to be shaped by a complex interplay of socio-demographic, medical, and psychological factors. However, there is a lack of research on the determinants of breastfeeding at 6 weeks postpartum. This study aimed to examine factors associated with exclusive breastfeeding (EBF) at 6 weeks postpartum in Southwest China and to provide evidence for early postpartum breastfeeding support. Sociodemographic information, infant feeding patterns at 6 weeks postpartum, and reasons for non-exclusive breastfeeding were collected using a self-designed questionnaire. Perinatal and postpartum clinical data were extracted from the electronic medical record system. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess postpartum depressive symptoms. Binary logistic regression analysis was used to identify factors associated with exclusive breastfeeding at 6 weeks postpartum. A total of 10,730 valid questionnaires were included, with a valid response rate of 93.4%. At 6 weeks postpartum, 6,478 mothers (60.4%) maintained EBF. This study found that the most commonly reported reason for discontinuing EBF was perceived insufficient milk supply ( n = 3,334, 78.4%). Factors associated with lower odds of EBF included maternal age ≥ 35 years, maternal illness severity, infectious diseases, postpartum hemorrhage, twin pregnancy, resumption of menstruation, and postpartum depressive symptoms. Factors associated with higher odds of EBF included higher educational level of the mother-in-law, multiparity, vaginal delivery, and infant NICU admission. At 6 weeks postpartum, EBF was associated with clinical, psychological, and family-related factors. The 6-week postpartum follow-up may provide an opportunity to identify mothers who need additional lactation and psychological support, particularly older mothers, mothers of twins, women after cesarean delivery, and those reporting depressive symptoms or concerns about milk supply.