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.