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3020 Children's Way, MC 5073
San Diego, CA 92123-4282
Phone: (858) 966-5981
Fax: (858) (858) 939-4972
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The relationship between maternal smoking and breastfeeding duration after adjustment for maternal feeding intention. Donath SM, Amir LH, ALSPAC Study Team. Acta Paediatr 2004; 93:1514-18.
Previous studies have shown that women who smoke are less likely to breastfeed and that smoking is associated with a shorter duration of breastfeeding. Research has also shown that prenatal infant feeding intention is a strong predictor of breastfeeding duration. Is the earlier weaning by mothers who smoke a physiologic effect of smoking on breastfeeding, or do these smoking mothers intend to breastfeed less often and for a shorter period of time? Over 14,000 women expecting to give birth 1992-4 were recruited for the Avon Longitudinal Study of Parents and Childhood (ALSPAC) in 3 Bristol-based health clinics of Avon, U.K, with complete data available for 11,111 women. Main outcome measures included maternal infant feeding intention at 32 weeks of pregnancy, intention for the first week, intention for the rest of the first month and intention in months 2 to 4. Maternal smoking was defined as any smoking reported at any time during pregnancy. Data on initiation and duration of breastfeeding were based on a |
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questionnaire at 6 months postpartum, supplemented by data from a 15-mo questionnaire if necessary.
RESULTS: Smoking mothers were younger and less educated than nonsmoking mothers. Women who smoked during pregnancy had an adjusted odds ratio of 1.5 (95% CI: 1.3-1.7) of not breastfeeding at 6 months compared to non-smokers (adjusting for maternal age, education and intention). Survival analysis of duration of breastfeeding in the first 6 months postpartum found that women who intended to breastfeed for less than 1 month were 78% more likely to stop at any given time than women planning to breastfeed for at least 4 mo, while smokers were 17% more likely to stop breastfeeding than non-smokers. This smaller difference (17%) could be due to the physical effects of smoking, or to unidentified confounders. CONCLUSION: Although women who smoke are less likely to breastfeed their infants than are non-smoking women, it appears that this is largely due to lower motivation to breastfeed rather than a physiological effect of smoking on their milk supply. Nancy E. Wight MD, IBCLC, FABM, FAAP |
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