ABSTRACT
This longitudinal observational study aimed to determine the rates of initiation, duration and correlates of breast-feeding by mothers living in a socioeconomically advantaged urban environment in Turkey. Healthy, term infants born at Ankara University Faculty of Medicine Hospital who would be brought to the well-child clinic regularly for at least 12 months were enrolled. Data on feeding practices were obtained at the 1st, 2nd, 3rd, 4th, 5th, 6th, 9th and 12th month well child care visits. Breast-feeding outcome was categorized based on recommendations by the World Health Organization (WHO). The majority of the 295 participating mothers were older than 20 years, high school graduates, and lived in apartment housing, and 54.6% were employed. The rates of breast-feeding were 97.9%, 90.1%, 76.9% and 36.9% at 1, 4, 6 and 12 months, respectively, and rates of exclusive breast-feeding were 89.8%, 59.3% and 2.0% at 1, 4 and 6 months, respectively. At 6 months 69.8% of infants were receiving cow's milk and by 12 months only 23.4% of the infants had been breast-fed according to WHO recommendations. Neither gender; birth weight of infant; age, education, parity, previous breast-feeding experience of mother; nor the status of living as extended versus nuclear family were related to breast-feeding outcome. Mothers who were working (RR: 3.89, 95% CI: 1.42-10.65) and those who had less than 4 months postpartum leave from work (RR: 4.20, 95% CI: 2.16-8.17) were more likely to not breast-feed optimally. The results of this study indicate that even where breast-feeding is normative behavior, it may not be optimally practiced, leading to potentially detrimental nutrition for infants. Promotion of breast-feeding even in advantaged urban populations is needed.
