The effect of prenatal education on exclusive breastfeeding among women in Quito. Prospective cohort study

The effect of prenatal education on exclusive breastfeeding among women in Quito. 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Prospective cohort study Betzabé Tello, Herminio Hernández, Iván Dueñas-Espín, Eduardo Tejera This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4493713/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 May, 2025 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted 11 You are reading this latest preprint version Abstract Background: Breast milk is the optimal food for humans, however, many mothers encounter difficulties sustaining exclusive breastfeeding (EBF). Prenatal education (PE) has been suggested as a potential strategy to promote EBF. There remains a gap in understanding how PE influences EBF duration. Methods: This prospective cohort study aimed to evaluate the effect of PE on EBF continuation among mothers who gave birth in private and public hospitals in Quito, Ecuador. A total of 278 participants were recruited, with 152 receiving PE and 126 not receiving it. Data was collected through structured surveys. Baseline clinical information was obtained through face-to-face interviews conducted after delivery and before discharge. Then, follow-up telephone interviews were conducted at one, four, and six months postpartum. Results: Comparisons between the exposed (PE) and unexposed groups revealed significant differences in education level, health insurance, antenatal care visits, rooming-in rates, parity, and maternal breastfeeding (BF) intentions. Participants who received PE demonstrated a significantly longer mean duration of EBF compared to those who did not (89.4 ± 77.2 days vs. 66.1 ± 70.2 days, p = 0.004). The incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. Cox survival analysis indicated a lower risk of EBF cessation among mothers who received PE (adjusted hazard ratio [aHR] = 0.58, 95% CI = 0.40-0.84, p = 0.004). Other factors associated with EBF discontinuation included delivery at a public health facility, postpartum depression, specific reasons for stopping BF, insufficient supply, return to work, healthcare provider recommendations, family advice, and negative BF experiences. Conclusion: Standardized PE programs have a significant and independent positive impact on EBF duration among mothers in Quito, Ecuador. These findings underscore the importance of integrating PE into routine prenatal care and providing comprehensive postpartum support to promote BF continuation. It is necessary to develop targeted interventions to address modifiable risk factors for BF cessation. Exclusive breastfeeding postpartum depression prenatal education public health practice maternal health Figures Figure 1 Figure 2 Background Breast milk is the optimal food for humans [ 1 ]. Breastfeeding (BF) offers numerous benefits to both mothers and children. It reduces health costs by lowering maternal and infant morbidity and mortality, and it's also beneficial for the environment as it's a natural, safe, and renewable resource [ 2 ]. BF fosters essential bonds between mothers and their children, contributing to the child's overall physical, psychoemotional, and social development [ 1 ]. Despite these well-documented benefits, globally, exclusive breastfeeding (EBF) rates remain suboptimal, and many mothers discontinue BF earlier than recommended [ 3 ]. Prenatal education (PE) programs provide expectant mothers with essential knowledge and support for pregnancy, childbirth, postpartum, and childcare. These programs include prenatal classes, counseling sessions, and educational materials aimed at promoting EBF [ 4 , 5 ]. While PE holds promise as a potential intervention to improve EBF rates, the evidence regarding its effectiveness remains inconclusive and subject to debate [ 6 ]. Several studies have investigated the impact of PE on EBF outcomes, yielding mixed results. Some studies have reported positive associations between PE and increased rates of EBF initiation and duration, suggesting that well-designed educational interventions can positively influence BF practices, however, the results of other studies that do not demonstrate this effect. Maybe there are heterogeneity of the research designs, the populations studied and the approaches and methodologies of the PE sessions that are not standardized [ 6 , 7 ]. In 2015, Ecuador mandated a PE program in public and private health facilities as part of strategies to reduce maternal mortality. The program includes six sessions on self-care during pregnancy, childbirth, and newborn care. However, no studies have evaluated its impact on breastfeeding. Given Quito's diverse cultural, social, and economic context, this study aims to assess the PE program's influence on BF practices. This study is based on the hypothesis that the standardized PE program increases women's knowledge and may positively influence the time women exclusively breastfeed. The findings will inform health authorities and related stakeholders to build strategies to promote and support exclusive breastfeeding in Quito and similar settings. Materials and methods Study design A prospective cohort study was developed in Quito, Ecuador's capital city, and it analyzed the effect of PE on EBF duration. The longitudinal design followed mother-infant dyads from childbirth to six months postpartum. Setting The study was conducted in Quito, on women who gave birth in public and private hospitals within the urban area. To contextualize, Quito has a population of approximately 2.78 million people, with a female majority of 51.7% identifying as mestizo (mixed ethnic background). Most women in Quito have completed primary and secondary education, with 33.7% having higher education qualifications [ 8 ]. Sampling The study population consisted of mothers, and their infants, who delivered in public and private hospitals in Quito. Recruitment occurred between May 2019 and March 2020 in the hospitals following delivery and before discharge. Sample Size Calculation Sample size calculation was performed using the GRANMO application version 7.12, aiming to detect a statistically significant relative risk of 1.5 or greater in the rate of EBF [ 9 ]. A convenience sampling method was employed to recruit 107 exposed and 107 non-exposed subjects, considering an alpha risk of 0.05 and a beta risk of 0.2 in a two-sided test. The prevalence of EBF at 5 months in the non-exposed group was estimated to be 40%, according to the National Health and Nutrition Survey of Ecuador in 2012. To account for a potential 30% loss to follow-up, 153 samples in each group were calculated [ 10 ]. Inclusion and exclusion criteria Inclusion criteria for exposed mothers included being in the postpartum period after delivery and before discharge, completing all six PE sessions, giving birth in the same healthcare facility, and being over 18 years old. Exclusion criteria for exposed mothers included declining participation in the study within 6 months postpartum, a history of prenatal depression, giving birth to infants requiring neonatal intensive care, and inability to be contacted after five attempts. Similar inclusion and exclusion criteria were applied to non-exposed mothers, except for attending six PE sessions. Data Collection : The cohort was divided based on exposure to PE. The data was gathered through structured surveys which were administered by trained interviewers. Informed consent was obtained before data collection and surveys were conducted at four distinct time points: after birth and before discharge in a face-to-face encounter; and, by phone, at one, four, and six months postpartum. Baseline clinical data were obtained through a review of perinatal clinical history records with written authorization from the participants and surveys were conducted face-to-face and included information on socio-economic and demographic status, obstetric history, prenatal education attendance, intentions regarding BF, and feeding practices for newborns while in the hospital. Follow-up telephone interviews were conducted once a month, at four and six months postpartum. These interviews aimed to collect information on infant feeding practices, maternal working status, and to administer the Patient Health Questionnaire 9 (PHQ9) for assessing depression [ 11 , 12 ]. The first follow-up telephone contact was initiated at one month postpartum, as postpartum depression is more prevalent during this period. The second follow-up contact was made at four months postpartum, aligning with the duration of maternity leave stipulated by the current Labour Code in Ecuador, which is of 12 weeks [ 13 ]. Additionally, some women extend this period by adding vacation days. The third follow-up contact occurred at six months postpartum to ascertain the EBF indicator [ 14 ]. All participants, at PE and not PE, received information on the importance of identifying postpartum depression, and those presenting with depression symptoms were referred to a healthcare facility for treatment. Variables: Dependent variable EBF before six months: Infants under six months that are exclusively fed with breast milk the day before the assessment. This was determined through specific questions regarding BF and consumption of liquids other than breast milk, supplemented by a recall approach assessing EBF duration since birth, following the operational definition of the World Health Organization [ 15 ]. The categorical dichotomous outcome variable (Maintenance/Abandonment) was encoded to represent two distinct states: Maintenance, indicating the continuation of EBF, and Abandonment, denoting any form of complementary feeding or cessation of EBF, additionally, EBF was also encoded as a continuous variable to capture the number of breastfeeding days reported by the mother [ 14 ]. Finally, incidence rates of abandonment were calculated for each group. Independent Variables Main explanatory variable: Prenatal education: To consider that the participants completed the program, they had to attend all six classes in the prenatal period. In Ecuador, the sessions are group-based and last for two hours, with the first hour focused on strengthening knowledge and self-care activities and the second hour devoted to physical exercises. Women can attend with a companion, with a maximum of 20 people in each group. The first session covered the importance of prenatal education, changes during pregnancy, and warning signs. The second session focuses on prenatal care activities, dietary hygiene measures, usual discomforts of pregnancy, birth plan, and the rights of users of health facilities. The third session is about preparing for childbirth, including uterine contractions (how to differentiate them from other changes and how to respond to their presence), control and registration of contractions, the difference between discomfort, pains, and fears, signs of beginning labor and when to go to health centers, differences between prodromes and labor, phases and benefits of natural birth and early skin-to-skin contact. The fourth session focuses on childbirth care, the fifth session is about breastfeeding and postpartum care and the final session covers preparing the pregnant woman for the childbirth environment. Other co-variables: The demographic variables analyzed include age, ethnicity, marital status, cohabitation, education, employment, occupation, and health insurance status. Obstetric variables examined include the frequency of antenatal visits, contraceptive use, medical history, health facility delivery, parity (primiparous or multiparous), mode of delivery (vaginal or cesarean), postpartum complications, presence of a companion during labor, skin-to-skin contact, and rooming-in. Infant feeding variables encompass early initiation of breastfeeding (newborns put to the breast within one hour of birth), feeding practices at discharge, maternal intentions regarding breastfeeding duration and method, reasons for discontinuation of EBF, alternative feeding methods, and access to support groups. Additionally, psychological, and social support variables include availability of household assistance, maternal leave policies, and assessment of postpartum depression at follow-up intervals after childbirth. Data Analysis : Chi-square tests and Mann-Whitney U tests were employed to compare categorical and continuous variables for the exposed PE group and the unexposed group concerning sociodemographic, obstetric characteristics, birth care, breastfeeding practice, introduction of complementary foods, psychological and social support variables (Table 1 – 2 ). Table 1 Demographic, obstetric characteristics, and birth care of participants in exposed (Prenatal Education) and unexposed groups (n = 278) Characteristics Exposed prenatal education (n = 152) M ± SD or n (%) Unexposed group (n = 126) M ± SD or n (%) P-value Demographic characteristics Age: means 27.9 ± 5.98 28.3 ± 6.40 0.567 Ethnicity 0.255 Mestizo (mixed ethnic background 136 (89.5) 107 (84.9) Others 16 (10.5) 19 (15.1) Marital Status 0.093 Married 53 (34.9) 59 (46.8) Cohabiting 61 (40.1) 37 (29.4) Others (Single, divorced, widow) 38 (25.0) 30 (23.8) Living with partner 0.849 Yes 134 (88.2) 112(88.9) No 18 (11.8) 14 (11.1) Education level 0.001 No education 1 (0.8) Primary 24 (15.8) 46 (36.5) Secondary 60 (39.5) 25 (19.8) University 68 (44.7) 54 (42.9) Employment status 0.419 Employed 52 (34.2) 49 (38.9) Unemployed 100 (65.8) 77 (61.1) Occupation Housework 89 (58.6) 83 (65.8) Public/private employee 52 (34.2) 41 (32.5) 0.769 Student 11 (7.2) 2 (1.7) Health Insurance < 0.001 Public Health Insurance 119 (78.3) 78 (61.9) Private Health Insurance 7 (4.6) 30 (23.8) Social Security Health Insurance 21 (13.8) 18 (14.3) Others 5(3.3) 0 (0) Obstetric characteristics and birth care Antenatal care number of visits 0.019 1–4 3 (2) 10 (7.9) ≥ 5 149 (98) 116 (92.1) Practicing contraception methods 0.898 Yes 70 (46.1) 59 (46.8) No 82 (53.9) 67 (53.2) Personal pathological history 0.571 No one 118 (77.6) 106 (84.1) Preeclampsia 10 (6.6) 6 (4.8) Hypothyroidism 4 (2.6) 3 (2.4) Diabetes 2 (1.3) 4 (3.2) Other 18 (11.9) 7 (5.5) Health facility delivery 0.007 Public 122 (80.3) 83 (65.9) Private 30 (19.7) 43 (34.1) Parity 0.003 Primiparous 95 (62.5) 56 (44.4) Multiparous 57 (37.5) 70 (55.6) Mode of delivery 0.104 Vaginal 92 (60.5) 64 (50.8) Cesarean 60 (39.5) 62 (49.2) Postpartum hypertension 0.459 No one 143 (94.1) 121 (96.0) Transient 9 (5.9) 5 (4.0) Postpartum infection 0.055 No one 147 (96.7) 111 (88.1) Vaginal infection 4 (2.6) 10 (7.9) Other 1 (0.7) 5 (4.0) Postpartum hemorrhage 0.233 No one 131 (86.2) 101(80.2) Genital tract tear 14 (9.2) 16 (12.7) Other 7 (4.6) 9 (7.1) Companion during labor and childbirth 0.712 Spouse/partner 112 (73.7) 94 (74.6) Other family members 32 (21.1) 23 (18.3) Other 8 (5.3) 9 (7.1) Skin-to-skin contact after delivery 0.197 Yes 103 (67.1) 76 (60.3) No 49 (32.9) 50 (39.7) 24-hour rooming-in 0.001 Yes 145 (95.4) 90 (71.4) No 7 (4.6) 36 (28.6) Early initiation of breastfeeding. 0.066 Yes 82 (53.9) 54 (42.9) No 70 (46.1) 72 (57.1) Infant feeding practice at hospital discharge 0.930 Exclusive breastfeeding 102 (66.4) 69 (54.8) Mixed breast and formula-feeding 50 (33.6) 57 (45.2) Maternal intention to breastfeed 0.105 Exclusive breastfeeding 152 (100) 121 (96) Mixed breast and formula-feeding 0 (0.0) 2 (1.6) Formula-feeding 0 (0.0) 1 (0.8) The recommendation given by a health care professional 0 (0.0) 2 (1.6) Maternal intention to breastfeed, months 0.003 > 12 months 123 (80.9) 80 (63.5) 6–12 months 27 (17.8) 35 (27.8) 0–6 months 2 (1.3) 11 (8.7) Decision on infant feeding method 0.278 Mother´s decision 88 (57.9) 73 (57.9) Health care professional 32 (21) 19 (15.1) Partner/family members 25 (16.5) 29 (23.0) Newspapers, magazines, brochures, television, internet sites 7 (4.6) 5 (4.0) P -values calculated using U de Mann-Whitney Table 2 Comparison of breastfeeding practices, introduction of complementary foods, psychological and social support over time in exposed (Prenatal Education) and unexposed groups Characteristics Exposed prenatal education (n = 152) M ± SD or n (%) Unexposed group (n = 126) M ± SD or n (%) P-value EBF duration: means 89.4 ± 77.2 66.1 ± 70.2 0.004 EBF (month 1) 0.145 Yes 94 (61.8) 67 (53.2) No 58 (38.2) 59 (46.8) EBF (month 4) 0.018 Yes 72 (47.4) 42 (33.3) No 80 (52.6) 84 (66.7) EBF (month 6) < 0.001 Yes 44 (28.9) 13 (10.3) No 108 (71.1) 113 (89.7) Reason for stopping exclusive BF (month 6) < 0.001 Ongoing breastfeeding 70 (46.1) 99 (78.6) Return to work 11 (7.2) 18 (14.3) Insufficient supply 9 (5.9) 7 (5.6) Family advice 24 (15.8) 0 (0.0) Healthcare provider recommendation to cease breastfeeding 32 (21.1) 2 (1.6) Others (Negative breastfeeding experiences, Lack of support from partner) 6 (3.9) 0 (0.0) Products used to replace BF until six months (month 1) 0.331 Nothing 94 (61.8) 67 (53.2) Breast milk substitutes (commercial infant formula) 19 (12.5) 23 (18.3) Other milk, colada drink, oatmeal porridge, herbal tea) 39 (26.5) 36 (31.5) Products used to replace BF until six months (month 4) < 0.001 Nothing 72 (47.4) 42 (33.3) Breast milk substitutes (commercial infant formula) 37 (24.3) 61 (48.4) Other milk, colada drink, oatmeal porridge, herbal tea) 38 (25) 20 (15.9) Soups 2 (1.3) 0 (0.0) Porridge 3 (2.0) 3 (2.4) Products used to replace BF until six months (month 6) < 0.001 Nothing 44 (28.9) 13 (10.3) Breast milk substitutes (commercial infant formula) 0 (0.0) 15 (11.9) Other milk, colada drink, oatmeal porridge, herbal tea) 22 (14.5) 2 (1.6) Soups 17 (11.2) 13 (10.3) Porridge 69 (45.4) 83 (65.9) BF support groups (month 1) 0.088 Yes 31 (20.4) 16 (12.7) No 121 (79.6) 110 (87.3) BF support groups (month 4) 0.394 Yes 22 (14.5) 23 (18.3) No 130 (85.5) 103 (81.7) BF support groups (month 6) 0.585 Yes 24 (15.8) 23 (18.3) No 128 (84.2) 103 (81.7) Psychological and social support Assistance with household labor (month 1) 0.165 None 68 (44.7) 46 (36.5) Others 84 (55.3) 80 (63.5) Assistance with household labor (month 4) 0.002 None 61 (40.1) 39 (31.0) Others 91 (59.9) 87 (69.0) Assistance with household labor (month 6) 0.004 None 59 (38.8) 38 (30.2) Others 93 (61.2) 88 (69.8) Maternity leave (month 4) < 0.001 Yes 33 (21.7) 6 (4.8) No 119 (78.3) 120 (95.2) Maternity leave (month 6) < 0.001 Yes 34 (22.4) 6 (4.8) No 118 (77.6) 120 (95.2) PPD (month 1) < 0.001 Yes 13 (8.6) 31 (24.6) No 139 (91.4) 95 (75.4) PPD (month 4) 0.466 Yes 20 (13.2) 13 (10.3) No 132 (86.8) 113 (89.7) PPD (month 6) 0.801 Yes 12 (7.9) 11 (8.7) No 140 (92.1) 115 (91.3) BF breastfeeding, EBF exclusive breastfeeding, PPD postpartum depression Values are means ± SDs (continuous) or n (%) (categorical) P -values were calculated using U de Mann-Whitney (continuous) or chi-square test (categorical) Table 3 The estimates obtained by the Cox regression model using this set of variables. The hazard rates and their respective 95% confidence intervals are shown for each statistically significant (p < 0.05) risk factor. Variable Crude HR (95% CI) (univariable) p-value Saturated model HR (95% CI) (multivariable) p-value Parsimonious model HR (95% CI) Prenatal education No Ref. Yes 0.58 (0.40–0.84) p = 0.004 0.29 (0.18–0.46) p < 0.001 0.29 (0.18–0.46) p < 0.001 Delivery at a public health facility No Ref. Yes 2.21 (1.12–4.38) p = 0.022 3.95 (1.69–9.22) p = 0.001 4.19 (1.98–8.82) p 6 months No Ref. Yes 0.41 (0.19–0.88) p = 0.022 0.54 (0.24–1.23) p = 0.147 0.48 (0.21–1.05) p = 0.067 Depression (month 4) No Ref. Yes 3.10 (1.93–4.98) P < 0.001 1.97 (1.00-3.86) p = 0.047 2.06 (1.24–3.41) p = 0.005 Employed months 6 No Ref. Yes 1.55 (1.06–2.27) p = 0.023 1.31 (0.79–2.15) p = 0.286 Reason for stopping exclusive BF (month 6) Ongoing breastfeeding (ref) Ref. Insufficient supply 3.27 (1.76–6.07) p < 0.001 2.39 (1.22–4.66) p = 0.010 2.38 (1.24–4.58) p = 0.009 Return to work 4.04 (2.25–7.23) p < 0.001 5.22 (2.49–10.94) p < 0.001 6.30 (3.33–11.93) p < 0.001 Healthcare provider recommendation to cease breastfeeding 3.61 (2.06–6.33) p < 0.001 4.75 (2.49–9.03) p < 0.001 4.24 (2.30–7.81) p < 0.001 Family advice 5.87 (3.08–11.18) p < 0.001 9.81 (4.41–21.8) p < 0.001 10.14 (4.69–21.89) p < 0.001 Others (Negative breastfeeding experiences, Lack of support from partner) 9.22 (3.23–26.32) p < 0.001 10.71 (3.37–33.99) p < 0.001 11.54 (3.71–35.82) p < 0.001 Depression (month 6) No Ref. Yes 2.06 (1.15–3.69) p = 0.015 1.00 (0.45–2.20) p = 0.999 Primiparous No Ref. Yes 1.27 (0.88–1.83) p = 0.209 1.78 (1.07–2.98) p = 0.026 1.83 (1.19–2.83) p = 0.006 Access to a breastfeeding support group (month 1) Yes Ref. No 1.64 (0.92–2.92) p = 0.095 1.43 (0.72–2.81) p = 0.297 1.48 (0.76–2.87) p = 0.238 EBF at hospital discharge No Ref. Yes 0.72 (0.45–1.16) p = 0.180 0.59 (0.35–0.99) p = 0.047 0.56 (0.33–0.93) p = 0.026 Mother´s decision on infant exclusive breastfeeding No Ref. Yes 0.52 (0.36–0.75) p = 0.001 0.82 (0.53–1.27) p = 0.385 Age of the mother (per each increase in one year) 0.96 (0.93–0.99) p = 0.016 1.00(0.96–1.04) p = 0.873 We calculated incidence rates of abandonment between both groups, PE and non-PE. The Kaplan-Meier curve, with the log-rank test, was employed to compare the survival duration until discontinuation of EBF between the PE group and the unexposed group. Univariate and multivariable forward stepwise Cox-proportional hazards regression models were used to identify predictors of breastfeeding cessation. Variables considered relevant in clinical practice and variables found to be statistically significant (p < 0.05) in univariate analysis were included in the multivariable regression models. Statistical analyses were performed using Stata 16.1 (StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC.) and Jamovi 2.3.28 (The Jamovi project 2024), and significance was determined based on confidence intervals and p-values (p < 0.05). Results The study comprised 307 participants, with 9.4% lost to follow-up as shown in Fig. 1 . The analysis included 152 in the exposed (received prenatal education) and 126 in the unexposed groups. The mean age was 28, mainly Mestizo (87.4%), with 40.3% married and 35.5% cohabiting. Most had secondary education (45.5%), unemployed (73.3%) and accessed public health facilities (73.7%). Obstetric data showed high antenatal care attendance (≥ 5 visits, 95.3%), not use of contraception methods (53.6%), and primiparity (54.3%). Vaginal delivery was common (56.1%), skin-to-skin contact (64.4%), and most intended to breastfeed exclusively (98.2%), with 51.5% practicing it at discharge. Comparison between groups showed similarities in age, ethnicity, marital status, and living arrangements but differed in education level and health insurance. The exposed group had more highly educated individuals and better public health insurance access. They had higher antenatal care visits (≥ 5) and 24-hour rooming-in. Parity and maternal breastfeeding intentions differed significantly (p < 0.05, chi-squared) (Table 1 ). Regarding breastfeeding practices, the exposed group had longer exclusive breastfeeding duration (89.4 ± 77.2 days) than the unexposed (66.1 ± 70.2 days), significant at p = 0.004 (Table 2 ). The incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. By month six, 28.9% in the exposed group practiced EBF compared to 10.3% in the unexposed (p < 0.001). Reasons for cessation EBF differed significantly (p < 0.001), with work return and milk supply cited more in the unexposed, while healthcare provider advice and family advice were more common in the exposed. The unexposed group had a higher use of breast milk substitutes at month four. Porridge was the main substitute for EBF at six months for the unexposed group. Furthermore, differences in psychological and social support, such as assistance with household labor and maternity leave, were observed between the groups across different time points (p < 0.001). The prevalence of postpartum depression varied significantly between the groups in the first month, 8.6% in the exposed group and 42.6% in the unexposed group (p < 0.001), but not at months 4 and 6. Kaplan-Meier survival analysis showed a significant difference in breastfeeding cessation risk between groups (adjusted hazard risk [aHR] = 0.58, 95% CI = 0.40–0.84, p = 0.004), with a protective effect of PE versus not receiving PE (Fig. 2 ). Cox regression models, adjusted by relevant co-variables, confirmed this, showing lower hazards in the exposed group by comparison with their counterparts (aHR = 0.29, 95% CI = 0.18–0.46, p < 0.001). Similarly, EBF at hospital discharge was associated with a decreased hazard of discontinuing EBF (aHR: 0.56, 95% CI: 0.33–0.93, p = 0.026). Other factors associated with cessation included public health facility delivery (aHR = 4.19, 95% CI: 1.98–8.82, p < 0.001), primiparity (aHR: 1.83, 95% CI: 1.19–2.83, p = 0.006), depression at month four (aHR = 2.06, 95% CI: 1.24–3.41, p = 0.005), specific reasons for stopping exclusive breastfeeding such as return to work (aHR: 6.30, 95% CI: 3.33–11.93, p < 0.001), healthcare provider recommendation to cease breastfeeding (aHR: 4.24, 95% CI: 2.30–7.81, p < 0.001), family advice (HR: 10.1, 95% CI: 4.69–21.89, p < 0.001), and other negative breastfeeding experiences (aHR: 11.54, 95% CI: 3.71–35.82, p < 0.001) were also found to increase the risk of discontinuation. Discussion EBF is crucial for infant health and development, but many mothers face challenges in maintaining it [ 16 ]. PE can help promote EBF by preparing expectant mothers for potential barriers [ 17 ]. Our study found that PE can act as a protective factor against EBF abandonment, highlighting the importance of standardized PE programs for promoting EBF. Similar to other studies, PE has been found to have a positive impact on the EBF of women [ 7 ]. Prenatal breastfeeding education not only enhances women's knowledge but also fosters a positive attitude towards breastfeeding, which can lead to its continuation for an extended period [ 18 ]. In our study, participants who received PE showed higher education levels, better access to public health insurance, and more antenatal care visits, indicating potential disparities in healthcare access and utilization. This highlights the importance of PE as a crucial element of breastfeeding support interventions. However, some studies have presented contrasting results, indicating no influence of PE on EBF prevalence [ 6 ]. It is important to note that diverse populations and geographic settings may contribute to these discrepancies, which can limit the generalizability of findings from this research to specific communities [ 19 ]. Maternal intention to breastfeed for six months or more was found to lower the risk of ceasing EBF, aligning with prior research indicating that intending EBF increases its duration [ 16 , 20 ]. In contrast, a US cohort study revealed that although more participants in the post-intervention group expressed intentions for any BF and aimed for a year or longer compared to the pre-intervention group, no significant difference was found in EBF rates between the two cohorts [ 21 ]. EBF at hospital discharge, as observed in this study, is vital for prolonged BF aligning with the literature. Supplementing with commercial milk formula during hospital stays often leads to premature BF discontinuation, particularly among women from lower socioeconomic backgrounds [ 22 ]. We found that factors influencing early cessation of BF include delivery at a public health facility, maternal depression, and specific reasons for stopping breastfeeding. Public health facility delivery emerged as a significant predictor of breastfeeding discontinuation. In a study in Mexico healthcare professionals often recommend commercial milk formula despite recognizing breastfeeding benefits, influencing maternal choices [ 23 ]. In our study maternal depression significantly relates to early BF cessation. In the first month, depression incidence was twice as high in the non-prenatal education group, evening out by months four and six. The presence of maternal depression may contribute to decreased motivation and ability to initiate and sustain BF. Addressing maternal mental health through support and resources could mitigate its detrimental effect on BF [ 2 ]. Other specific reasons for stopping breastfeeding were also found in our study to influence early cessation, including insufficient milk supply, return to work, and healthcare provider recommendations to cease BF [ 2 ]. These findings corroborate the importance of addressing individual barriers and challenges faced by mothers in their BF journey. Providing tailored support and resources to address these specific concerns could help mothers overcome obstacles and continue BF for longer durations [ 2 ]. We found that family advice and negative breastfeeding experiences were identified as additional factors contributing to early BF cessation. The influence of family and social support on BF decisions is crucial. Interventions promoting positive support and accurate BF information can create an environment conducive to BF success. Our study identified differences in the use of alternative products to replace BF between the exposed and unexposed groups. The unexposed group exhibited a higher prevalence of using breast milk substitutes and other milk alternatives, indicating a potential lack of support for EBF in this group. Notably, porridge emerged as the predominant substitute for EBF at six months, particularly among the unexposed group. Understanding these factors is crucial for developing targeted interventions to support breastfeeding continuation. By addressing modifiable risk factors and providing adequate support, healthcare providers can help mothers overcome barriers to breastfeeding [ 24 ]. The study findings show that there is an urgent need for action to support breastfeeding mothers and improve maternal and child health outcomes. To achieve this, comprehensive PE programs and BF support initiatives should be enhanced. Integrating BF education into routine prenatal care visits is essential, but it's important to recognize that limited healthcare setting hours and the availability of support groups may present barriers for some women. Additionally, exploring alternative educational settings can further reinforce the importance of BF practice. Lactation consultants and peer support groups should be made readily available to all mothers. Workplace policies should also be implemented to support BF mothers. Policymakers and healthcare providers can promote BF to improve maternal and child health outcomes and the overall well-being of families and communities. Strengths of the study include its prospective design, a standardized intervention, robust statistical analysis, and inclusion of relevant covariates. These aspects enhance the validity and reliability of the findings. It is important to note that there are certain limitations to the study. One potential limitation is the presence of selection bias, meaning that the participants who chose to take part in the PE program could be more motivated than others; nevertheless, when searching for potential confounders during modeling it was possible to calculate reliable adjusted estimates of the risk of abandonment, minimizing the risk of selection bias. Additionally, the data collected for this study was self-reported, which may also have limitations, but the fact of collecting the information just after birth, and corroborating the data by exploding the clinical records reduced the risk of information bias. Areas for future research include investigating the long-term effects of PE on BF outcomes, how and to what extent education courses should be, and exploring the cultural and contextual factors that influence BF practices. A clinical trial and a methodology that fits the local context are steps that can be taken for new research in this field. Conclusions This study shows that PE independently and significantly increases the duration of EBF. Integrating PE into prenatal care can bolster support for BF mothers. Tailored strategies addressing factors like delivery setting, maternal depression, and reason for cessation are important covariates. Evidence-based intervention, including adherence to the International Code of Marketing of Breast-milk Substitutes, lactation support, postpartum depression screening, and workplace policies are essential for fostering a supportive BF environment and improving maternal and child health outcomes. Abbreviations BF Breastfeeding EBF Exclusive breastfeeding HR Hazard Ratio PPD Post partum depression PE Prenatal Education SD Standard Deviation Declarations Ethics approval and consent to participate The research protocol was approved by the Institutional Research Ethics Committee (CIEI-Human) of the Universidad Peruana Cayetano Heredia (Certificate 093-05-17 dated February 17, 2017) and by the Ethics Committee for Research in Human Subjects of the Pontifical Catholic University of Ecuador (Letter CEISH-736-2019 dated April 30, 2019). Informed consent was obtained from all participants before enrollment under the Declaration of Helsinki. Measures were taken to ensure participant confidentiality and privacy throughout the study. Consent for publication Not applicable Availability of data and materials Availability of Data and Materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding The author(s) received no specific funding for this work. Authors’ Contributions Conceptualization: BT, HH.; Methodology: BT, HH; Formal analysis: BT, HH, ID-E, ET; Writing - original draft preparation: BT.; Writing - review and editing: BT, HH, ID-D, ET.; Supervision: HH, ID-E. All authors contributed to the article and approved the submitted version. Acknowledgements We would like to express our gratitude to Dr. Oswaldo Vásconez, Dr. César Carrillo, Dr. Edison Chávez, Dr. Luis Suárez, Dr. Juan Panchi, Dr. Jorge Peñaherrera, Dr. Andrés Sotomayor, Dr. Carlos Tello Ponce, Dra. Luciana Armijos, Dra. Ana Villacrés, Dra. Piedad Villacís, MSc. Esteban Zapata, Dra. Sabrina Morales, Dra. Klaudia Wolff, Dr. Rodrigo Henríquez and Dr. Pedro Saona. We would also like to thank the individuals in the health care settings who helped us promote the survey advertisements and the women who invested their time in completing the survey. References Lyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast milk, a source of beneficial microbes and associated benefits for infant health. Nutrients. 2020;12:1–30. Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491–504. Boccolini CS, Lacerda EMDA, Bertoni N, Oliveira N, Alves-Santos NH, Farias DR, et al. Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets. BMJ Glob Heal. 2023;8:1–11. Alizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth. 2023;23:1–26. Oggero MK, Rozmus CL, LoBiondo-Wood G. Effects of Prenatal Breastfeeding Education on Breastfeeding Duration Beyond 12 Weeks: A Systematic Review. Heal Educ Behav. 2024. https://doi.org/10.1177/10901981231220668 . Lumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev. 2016. https://doi.org/10.1002/14651858.CD006425.pub4 . Kehinde J, O’Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023;118. Instituto Nacional de Estadísticas y Censos. Mujeres y hombres del Ecuador en cifras III. Serie informática estratégica. INEC. 2014. Marrugat J. Calculadora de Grandària Mostral GRANMO versió 7.12. Institut Municipal D’investigació Mèdica. Institut de Rercerca Hospital del Mar; 2012. Freire W, Ramírez MJ, Belmont P, Mendieta MJ, Silva K, Romero N et al. Resumen Ejecutivo. Tomo I. Encuesta Nacional de Salud y Nutrición. ENSANUT-ECU 2011–2013. Primera. Quito Ecuador; 2013. Santos IS, Tavares BF, Munhoz TN, Manzolli P, De Ávila GB, Jannke E, et al. Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: A cross-sectional population-based study. BMC Res Notes. 2016;9:4–9. ACOG. Screening for perinatal depression. Replace Comm Opin. 2018;132:208–12. García Alarcón RE. Lactancia: derecho garantizado en el sistema jurídico ecuatoriano. Una mirada desde el enfoque de género y la doctrina de protección integral de la niñez. Rev la Fac Derecho y Ciencias Políticas. 2019;49:327–60. Organización Mundial de la Salud. Indicadores para evaluar las prácticas de alimentación del lactante y del niño pequeño. Parte 1 Definiciones. Conclusiones de la reunión de consenso llevada a cabo del 6 al 8 de noviembre de 2007 en Washington, DC, EE.UU. Primera. Washington D.C.; 2009. World Health Organization. United Nations Childrens’s Fund. Indicators for assessing infant and young child feeding practices: definitions and measurement methods. Geneva; 2021. Giang HTN, Duy DTT, Vuong NL, Ngoc NTT, Pham TT, Duc NTM, et al. Prevalence of exclusive breastfeeding for the first six months of an infant’s life and associated factors in a low–middle income country. Int Breastfeed J. 2023;18:1–11. Shafaei FS, Mirghafourvand M, Havizari S. The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: A randomized controlled clinical trial. BMC Womens Health. 2020;20:1–10. Berwick M, Louis-Jacques AF. Prenatal Counseling and Preparation for Breastfeeding. Obstet Gynecol Clin North Am. 2023;50:549–65. Jacobsen N. Antenatal breastfeeding education and support summary and analysis of 2 cochrane publications. J Perinat Neonatal Nurs. 2018;32:144–52. Wu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; August 2021:1–14. Rosen-Carole C, Halterman J, Baldwin CD, Martin H, Goldstein NPN, Allen K, et al. Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women’s Prenatal Breastfeeding Support, Intentions, and Outcomes. J Hum Lact. 2022;38:64–74. Vehling L, Chan D, McGavock J, Becker AB, Subbarao P, Moraes TJ, et al. Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity. Birth. 2018;45:440–9. Hernández-Cordero S, Vilar-Compte M, Tomori C, Lara-Mejía V, Rovelo-Velázquez N, Hayes K et al. Healthcare professionals and commercial milk formula recommendations in the urban Mexican context. Front Public Heal. 2023;11. Hernández-Cordero S, Pérez-Escamilla R. What will it take to increase breastfeeding? Matern Child Nutr. 2022;18:1–5. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 02 May, 2025 Read the published version in BMC Pregnancy and Childbirth → Version 1 posted Editorial decision: Revision requested 18 Mar, 2025 Reviews received at journal 05 Mar, 2025 Reviewers agreed at journal 27 Feb, 2025 Reviews received at journal 06 Aug, 2024 Reviewers agreed at journal 05 Aug, 2024 Reviewers agreed at journal 26 Jul, 2024 Reviewers invited by journal 17 Jul, 2024 Editor invited by journal 31 May, 2024 Editor assigned by journal 30 May, 2024 Submission checks completed at journal 30 May, 2024 First submitted to journal 28 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4493713","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309590692,"identity":"d3051ba1-03f5-492e-a560-ff7d764ce873","order_by":0,"name":"Betzabé Tello","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2UlEQVRIiWNgGAWjYBACAxDxoIBBDspnJkYLUFGCAYMx6VoSG4jWYi52/uCDBAOb9O0SyQ8fMFRYJzawNz/Aq8VydjKzQYJBWu7OGWnGBgxn0hMbeI4Z4HfY7WQ2iQSDw7kbbuSwSTC2HU5skMgh4Jfbyew/gFrSDW7ksP9g/AfUIv+GoBY2oPcPJwC1sDEwNoBs4cGvBegXY6DD0gx39jwDMo6lG7fxpOH3i7l04sMPHyps5M3Zk4GMGmvZfvbDD/BbA3chiEgAYjbi1MO0jIJRMApGwSjABgBHnULiO5RHJwAAAABJRU5ErkJggg==","orcid":"","institution":"Pontificia Universidad Católica del Ecuador, 12 de Octubre and Roca","correspondingAuthor":true,"prefix":"","firstName":"Betzabé","middleName":"","lastName":"Tello","suffix":""},{"id":309590693,"identity":"48cc3a42-22b0-424b-87a1-5b22448986b1","order_by":1,"name":"Herminio Hernández","email":"","orcid":"","institution":"Cayetano Heredia University","correspondingAuthor":false,"prefix":"","firstName":"Herminio","middleName":"","lastName":"Hernández","suffix":""},{"id":309590694,"identity":"5001e641-d27d-4387-9c83-96871d899ce0","order_by":2,"name":"Iván Dueñas-Espín","email":"","orcid":"","institution":"Pontificia Universidad Católica del Ecuador, 12 de Octubre and Roca","correspondingAuthor":false,"prefix":"","firstName":"Iván","middleName":"","lastName":"Dueñas-Espín","suffix":""},{"id":309590695,"identity":"e2f78ccb-d0bb-4bd6-ac46-86e0b9f18c44","order_by":3,"name":"Eduardo Tejera","email":"","orcid":"","institution":"Universidad de las Américas","correspondingAuthor":false,"prefix":"","firstName":"Eduardo","middleName":"","lastName":"Tejera","suffix":""}],"badges":[],"createdAt":"2024-05-29 02:17:03","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4493713/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4493713/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12884-025-07651-8","type":"published","date":"2025-05-02T15:56:59+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":58315856,"identity":"0ba783ab-4f0a-49ab-965a-adfd393cad08","added_by":"auto","created_at":"2024-06-13 21:00:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":72063,"visible":true,"origin":"","legend":"\u003cp\u003eFlow diagram of participants’ recruitment\u003c/p\u003e","description":"","filename":"Figure1.Flowchartpdf.png","url":"https://assets-eu.researchsquare.com/files/rs-4493713/v1/3b641c4ace39eeec3eb75d77.png"},{"id":58315855,"identity":"e29280b9-88cf-41bb-9ebc-59a6f12f04bb","added_by":"auto","created_at":"2024-06-13 21:00:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":66506,"visible":true,"origin":"","legend":"\u003cp\u003eKaplan-Meier plot of time to abandoning EBF among women who received and not PE\u003c/p\u003e","description":"","filename":"Figure2.SurvivalanalysisprenataleducationandEBF.png","url":"https://assets-eu.researchsquare.com/files/rs-4493713/v1/66e4e95e802e75a6562d35a8.png"},{"id":81987690,"identity":"00008248-30c6-4f36-9a42-543565e0238d","added_by":"auto","created_at":"2025-05-05 16:04:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1598489,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4493713/v1/923852d7-9f2b-448c-84af-cff40ed91c9a.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of prenatal education on exclusive breastfeeding among women in Quito. Prospective cohort study","fulltext":[{"header":"Background","content":"\u003cp\u003eBreast milk is the optimal food for humans [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Breastfeeding (BF) offers numerous benefits to both mothers and children. It reduces health costs by lowering maternal and infant morbidity and mortality, and it's also beneficial for the environment as it's a natural, safe, and renewable resource [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. BF fosters essential bonds between mothers and their children, contributing to the child's overall physical, psychoemotional, and social development [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Despite these well-documented benefits, globally, exclusive breastfeeding (EBF) rates remain suboptimal, and many mothers discontinue BF earlier than recommended [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrenatal education (PE) programs provide expectant mothers with essential knowledge and support for pregnancy, childbirth, postpartum, and childcare. These programs include prenatal classes, counseling sessions, and educational materials aimed at promoting EBF [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. While PE holds promise as a potential intervention to improve EBF rates, the evidence regarding its effectiveness remains inconclusive and subject to debate [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral studies have investigated the impact of PE on EBF outcomes, yielding mixed results. Some studies have reported positive associations between PE and increased rates of EBF initiation and duration, suggesting that well-designed educational interventions can positively influence BF practices, however, the results of other studies that do not demonstrate this effect. Maybe there are heterogeneity of the research designs, the populations studied and the approaches and methodologies of the PE sessions that are not standardized [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn 2015, Ecuador mandated a PE program in public and private health facilities as part of strategies to reduce maternal mortality. The program includes six sessions on self-care during pregnancy, childbirth, and newborn care. However, no studies have evaluated its impact on breastfeeding. Given Quito's diverse cultural, social, and economic context, this study aims to assess the PE program's influence on BF practices. This study is based on the hypothesis that the standardized PE program increases women's knowledge and may positively influence the time women exclusively breastfeed. The findings will inform health authorities and related stakeholders to build strategies to promote and support exclusive breastfeeding in Quito and similar settings.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eA prospective cohort study was developed in Quito, Ecuador's capital city, and it analyzed the effect of PE on EBF duration. The longitudinal design followed mother-infant dyads from childbirth to six months postpartum.\u003c/p\u003e \u003cp\u003eSetting\u003c/p\u003e \u003cp\u003eThe study was conducted in Quito, on women who gave birth in public and private hospitals within the urban area. To contextualize, Quito has a population of approximately 2.78\u0026nbsp;million people, with a female majority of 51.7% identifying as mestizo (mixed ethnic background). Most women in Quito have completed primary and secondary education, with 33.7% having higher education qualifications [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eSampling\u003c/h2\u003e \u003cp\u003eThe study population consisted of mothers, and their infants, who delivered in public and private hospitals in Quito. Recruitment occurred between May 2019 and March 2020 in the hospitals following delivery and before discharge.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eSample Size Calculation\u003c/h2\u003e \u003cp\u003eSample size calculation was performed using the GRANMO application version 7.12, aiming to detect a statistically significant relative risk of 1.5 or greater in the rate of EBF [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. A convenience sampling method was employed to recruit 107 exposed and 107 non-exposed subjects, considering an alpha risk of 0.05 and a beta risk of 0.2 in a two-sided test. The prevalence of EBF at 5 months in the non-exposed group was estimated to be 40%, according to the National Health and Nutrition Survey of Ecuador in 2012. To account for a potential 30% loss to follow-up, 153 samples in each group were calculated [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eInclusion criteria for exposed mothers included being in the postpartum period after delivery and before discharge, completing all six PE sessions, giving birth in the same healthcare facility, and being over 18 years old.\u003c/p\u003e \u003cp\u003eExclusion criteria for exposed mothers included declining participation in the study within 6 months postpartum, a history of prenatal depression, giving birth to infants requiring neonatal intensive care, and inability to be contacted after five attempts.\u003c/p\u003e \u003cp\u003eSimilar inclusion and exclusion criteria were applied to non-exposed mothers, except for attending six PE sessions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e\u003cem\u003eData Collection\u003c/em\u003e:\u003c/h2\u003e \u003cp\u003eThe cohort was divided based on exposure to PE. The data was gathered through structured surveys which were administered by trained interviewers. Informed consent was obtained before data collection and surveys were conducted at four distinct time points: after birth and before discharge in a face-to-face encounter; and, by phone, at one, four, and six months postpartum.\u003c/p\u003e \u003cp\u003eBaseline clinical data were obtained through a review of perinatal clinical history records with written authorization from the participants and surveys were conducted face-to-face and included information on socio-economic and demographic status, obstetric history, prenatal education attendance, intentions regarding BF, and feeding practices for newborns while in the hospital.\u003c/p\u003e \u003cp\u003eFollow-up telephone interviews were conducted once a month, at four and six months postpartum. These interviews aimed to collect information on infant feeding practices, maternal working status, and to administer the Patient Health Questionnaire 9 (PHQ9) for assessing depression [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The first follow-up telephone contact was initiated at one month postpartum, as postpartum depression is more prevalent during this period. The second follow-up contact was made at four months postpartum, aligning with the duration of maternity leave stipulated by the current Labour Code in Ecuador, which is of 12 weeks [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Additionally, some women extend this period by adding vacation days. The third follow-up contact occurred at six months postpartum to ascertain the EBF indicator [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. All participants, at PE and not PE, received information on the importance of identifying postpartum depression, and those presenting with depression symptoms were referred to a healthcare facility for treatment.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eVariables:\u003c/h2\u003e \u003cp\u003eDependent variable\u003c/p\u003e \u003cp\u003eEBF before six months: Infants under six months that are exclusively fed with breast milk the day before the assessment. This was determined through specific questions regarding BF and consumption of liquids other than breast milk, supplemented by a recall approach assessing EBF duration since birth, following the operational definition of the World Health Organization [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The categorical dichotomous outcome variable (Maintenance/Abandonment) was encoded to represent two distinct states: Maintenance, indicating the continuation of EBF, and Abandonment, denoting any form of complementary feeding or cessation of EBF, additionally, EBF was also encoded as a continuous variable to capture the number of breastfeeding days reported by the mother [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Finally, incidence rates of abandonment were calculated for each group.\u003c/p\u003e \u003cp\u003eIndependent Variables\u003c/p\u003e \u003cp\u003eMain explanatory variable:\u003c/p\u003e \u003cp\u003ePrenatal education: To consider that the participants completed the program, they had to attend all six classes in the prenatal period. In Ecuador, the sessions are group-based and last for two hours, with the first hour focused on strengthening knowledge and self-care activities and the second hour devoted to physical exercises. Women can attend with a companion, with a maximum of 20 people in each group. The first session covered the importance of prenatal education, changes during pregnancy, and warning signs. The second session focuses on prenatal care activities, dietary hygiene measures, usual discomforts of pregnancy, birth plan, and the rights of users of health facilities. The third session is about preparing for childbirth, including uterine contractions (how to differentiate them from other changes and how to respond to their presence), control and registration of contractions, the difference between discomfort, pains, and fears, signs of beginning labor and when to go to health centers, differences between prodromes and labor, phases and benefits of natural birth and early skin-to-skin contact. The fourth session focuses on childbirth care, the fifth session is about breastfeeding and postpartum care and the final session covers preparing the pregnant woman for the childbirth environment.\u003c/p\u003e \u003cp\u003eOther co-variables: The demographic variables analyzed include age, ethnicity, marital status, cohabitation, education, employment, occupation, and health insurance status. Obstetric variables examined include the frequency of antenatal visits, contraceptive use, medical history, health facility delivery, parity (primiparous or multiparous), mode of delivery (vaginal or cesarean), postpartum complications, presence of a companion during labor, skin-to-skin contact, and rooming-in. Infant feeding variables encompass early initiation of breastfeeding (newborns put to the breast within one hour of birth), feeding practices at discharge, maternal intentions regarding breastfeeding duration and method, reasons for discontinuation of EBF, alternative feeding methods, and access to support groups. Additionally, psychological, and social support variables include availability of household assistance, maternal leave policies, and assessment of postpartum depression at follow-up intervals after childbirth.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e\u003cem\u003eData Analysis\u003c/em\u003e:\u003c/h2\u003e \u003cp\u003eChi-square tests and Mann-Whitney U tests were employed to compare categorical and continuous variables for the exposed PE group and the unexposed group concerning sociodemographic, obstetric characteristics, birth care, breastfeeding practice, introduction of complementary foods, psychological and social support variables (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic, obstetric characteristics, and birth care of participants in exposed (Prenatal Education) and unexposed groups (n\u0026thinsp;=\u0026thinsp;278)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExposed prenatal education (n\u0026thinsp;=\u0026thinsp;152)\u003c/p\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnexposed group (n\u0026thinsp;=\u0026thinsp;126)\u003c/p\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDemographic characteristics\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge: means\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.9\u0026thinsp;\u0026plusmn;\u0026thinsp;5.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.3\u0026thinsp;\u0026plusmn;\u0026thinsp;6.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.255\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMestizo (mixed ethnic background\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e136 (89.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107 (84.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53 (34.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (46.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCohabiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (40.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers (Single, divorced, widow)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLiving with partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.849\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e134 (88.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(88.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (11.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 (11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (36.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (39.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (19.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68 (44.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.419\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (38.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (65.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77 (61.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousework\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89 (58.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (65.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic/private employee\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52 (34.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (32.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.769\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStudent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic Health Insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e119 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78 (61.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate Health Insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Security Health Insurance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eObstetric characteristics and birth care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntenatal care number of visits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149 (98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e116 (92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePracticing contraception methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.898\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (46.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (46.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (53.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonal pathological history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e118 (77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106 (84.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePreeclampsia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (6.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypothyroidism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (5.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth facility delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e122 (80.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (65.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (19.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMode of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92 (60.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64 (50.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCesarean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60 (39.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (49.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostpartum hypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.459\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143 (94.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121 (96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTransient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostpartum infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e147 (96.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111 (88.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVaginal infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostpartum hemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo one\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e131 (86.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101(80.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGenital tract tear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompanion during labor and childbirth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.712\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpouse/partner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112 (73.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (74.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther family members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkin-to-skin contact after delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.197\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103 (67.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (60.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49 (32.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (39.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24-hour rooming-in\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e145 (95.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90 (71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly initiation of breastfeeding.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (46.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72 (57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfant feeding practice at hospital discharge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.930\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExclusive breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e102 (66.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (54.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMixed breast and formula-feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (33.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (45.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal intention to breastfeed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExclusive breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e152 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121 (96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMixed breast and formula-feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormula-feeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe recommendation given by a health care professional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal intention to breastfeed, months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e123 (80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (63.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;12 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDecision on infant feeding method\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.278\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u0026acute;s decision\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88 (57.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73 (57.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth care professional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartner/family members\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (23.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNewspapers, magazines, brochures, television, internet sites\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cem\u003eP\u003c/em\u003e-values calculated using U de Mann-Whitney\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of breastfeeding practices, introduction of complementary foods, psychological and social support over time in exposed (Prenatal Education) and unexposed groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExposed prenatal education (n\u0026thinsp;=\u0026thinsp;152)\u003c/p\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnexposed group (n\u0026thinsp;=\u0026thinsp;126)\u003c/p\u003e \u003cp\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBF duration: means\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e89.4\u0026thinsp;\u0026plusmn;\u0026thinsp;77.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.1\u0026thinsp;\u0026plusmn;\u0026thinsp;70.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBF (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (61.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (53.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58 (38.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (46.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBF (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.018\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (47.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (52.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBF (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e108 (71.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113 (89.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReason for stopping exclusive BF (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOngoing breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (46.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99 (78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReturn to work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (14.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsufficient supply\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealthcare provider recommendation to cease breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers (Negative breastfeeding experiences, Lack of support from partner)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProducts used to replace BF until six months (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.331\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e94 (61.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67 (53.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreast milk substitutes (commercial infant formula)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther milk, colada drink, oatmeal porridge, herbal tea)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39 (26.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (31.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProducts used to replace BF until six months (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (47.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreast milk substitutes (commercial infant formula)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37 (24.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (48.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther milk, colada drink, oatmeal porridge, herbal tea)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSoups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePorridge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProducts used to replace BF until six months (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBreast milk substitutes (commercial infant formula)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther milk, colada drink, oatmeal porridge, herbal tea)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSoups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17 (11.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePorridge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (45.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83 (65.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBF support groups (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e121 (79.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110 (87.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBF support groups (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.394\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (14.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (85.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103 (81.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBF support groups (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.585\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e128 (84.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e103 (81.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePsychological and social support\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssistance with household labor (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68 (44.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46 (36.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84 (55.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (63.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssistance with household labor (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61 (40.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (31.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91 (59.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (69.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssistance with household labor (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59 (38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38 (30.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93 (61.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88 (69.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternity leave (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e119 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternity leave (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (22.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e118 (77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 (95.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPD (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (24.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e139 (91.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95 (75.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPD (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (13.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (10.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e132 (86.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113 (89.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPD (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (7.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (92.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115 (91.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eBF breastfeeding, EBF exclusive breastfeeding, PPD postpartum depression\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are means\u0026thinsp;\u0026plusmn;\u0026thinsp;SDs (continuous) or n (%) (categorical)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003cem\u003eP\u003c/em\u003e-values were calculated using U de Mann-Whitney (continuous) or chi-square test (categorical)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe estimates obtained by the Cox regression model using this set of variables. The hazard rates and their respective 95% confidence intervals are shown for each statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) risk factor.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCrude HR (95% CI)\u003c/p\u003e \u003cp\u003e(univariable)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSaturated model\u003c/p\u003e \u003cp\u003eHR (95% CI) (multivariable)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eParsimonious model\u003c/p\u003e \u003cp\u003eHR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrenatal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.58 (0.40\u0026ndash;0.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.29 (0.18\u0026ndash;0.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.29 (0.18\u0026ndash;0.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDelivery at a public health facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.21 (1.12\u0026ndash;4.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.95 (1.69\u0026ndash;9.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.19 (1.98\u0026ndash;8.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePracticing contraception methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.57 (0.39\u0026ndash;0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.91 (0.60\u0026ndash;1.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.697\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternal intention to breastfeed, \u0026gt; 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.41 (0.19\u0026ndash;0.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.54 (0.24\u0026ndash;1.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.147\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.48 (0.21\u0026ndash;1.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression (month 4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.10 (1.93\u0026ndash;4.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.97 (1.00-3.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.06 (1.24\u0026ndash;3.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed months 6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.55 (1.06\u0026ndash;2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.31 (0.79\u0026ndash;2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReason for stopping exclusive BF (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOngoing breastfeeding (ref)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsufficient supply\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.27 (1.76\u0026ndash;6.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.39 (1.22\u0026ndash;4.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.38 (1.24\u0026ndash;4.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eReturn to work\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.04 (2.25\u0026ndash;7.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.22 (2.49\u0026ndash;10.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.30 (3.33\u0026ndash;11.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealthcare provider recommendation to cease breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.61 (2.06\u0026ndash;6.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.75 (2.49\u0026ndash;9.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.24 (2.30\u0026ndash;7.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.87 (3.08\u0026ndash;11.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.81 (4.41\u0026ndash;21.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10.14 (4.69\u0026ndash;21.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers (Negative breastfeeding experiences, Lack of support from partner)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.22 (3.23\u0026ndash;26.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.71 (3.37\u0026ndash;33.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e11.54 (3.71\u0026ndash;35.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression (month 6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.06 (1.15\u0026ndash;3.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.015\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00 (0.45\u0026ndash;2.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.27 (0.88\u0026ndash;1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.78 (1.07\u0026ndash;2.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.83 (1.19\u0026ndash;2.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess to a breastfeeding support group (month 1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.64 (0.92\u0026ndash;2.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.095\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.43 (0.72\u0026ndash;2.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.48 (0.76\u0026ndash;2.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.238\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEBF at hospital discharge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.72 (0.45\u0026ndash;1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.180\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.59 (0.35\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.047\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.56 (0.33\u0026ndash;0.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMother\u0026acute;s decision on infant exclusive breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRef.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.52 (0.36\u0026ndash;0.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.82 (0.53\u0026ndash;1.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.385\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge of the mother (per each increase in one year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.96 (0.93\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00(0.96\u0026ndash;1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.873\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWe calculated incidence rates of abandonment between both groups, PE and non-PE. The Kaplan-Meier curve, with the log-rank test, was employed to compare the survival duration until discontinuation of EBF between the PE group and the unexposed group.\u003c/p\u003e \u003cp\u003eUnivariate and multivariable forward stepwise Cox-proportional hazards regression models were used to identify predictors of breastfeeding cessation. Variables considered relevant in clinical practice and variables found to be statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in univariate analysis were included in the multivariable regression models. Statistical analyses were performed using Stata 16.1 (StataCorp. 2019. Stata Statistical Software: Release 16. College Station, TX: StataCorp LLC.) and Jamovi 2.3.28 (The Jamovi project 2024), and significance was determined based on confidence intervals and p-values (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe study comprised 307 participants, with 9.4% lost to follow-up as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The analysis included 152 in the exposed (received prenatal education) and 126 in the unexposed groups. The mean age was 28, mainly Mestizo (87.4%), with 40.3% married and 35.5% cohabiting. Most had secondary education (45.5%), unemployed (73.3%) and accessed public health facilities (73.7%). Obstetric data showed high antenatal care attendance (\u0026ge;\u0026thinsp;5 visits, 95.3%), not use of contraception methods (53.6%), and primiparity (54.3%). Vaginal delivery was common (56.1%), skin-to-skin contact (64.4%), and most intended to breastfeed exclusively (98.2%), with 51.5% practicing it at discharge.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eComparison between groups showed similarities in age, ethnicity, marital status, and living arrangements but differed in education level and health insurance. The exposed group had more highly educated individuals and better public health insurance access. They had higher antenatal care visits (\u0026ge;\u0026thinsp;5) and 24-hour rooming-in. Parity and maternal breastfeeding intentions differed significantly (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, chi-squared) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding breastfeeding practices, the exposed group had longer exclusive breastfeeding duration (89.4\u0026thinsp;\u0026plusmn;\u0026thinsp;77.2 days) than the unexposed (66.1\u0026thinsp;\u0026plusmn;\u0026thinsp;70.2 days), significant at p\u0026thinsp;=\u0026thinsp;0.004 (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. By month six, 28.9% in the exposed group practiced EBF compared to 10.3% in the unexposed (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Reasons for cessation EBF differed significantly (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with work return and milk supply cited more in the unexposed, while healthcare provider advice and family advice were more common in the exposed. The unexposed group had a higher use of breast milk substitutes at month four. Porridge was the main substitute for EBF at six months for the unexposed group. Furthermore, differences in psychological and social support, such as assistance with household labor and maternity leave, were observed between the groups across different time points (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The prevalence of postpartum depression varied significantly between the groups in the first month, 8.6% in the exposed group and 42.6% in the unexposed group (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), but not at months 4 and 6.\u003c/p\u003e \u003cp\u003eKaplan-Meier survival analysis showed a significant difference in breastfeeding cessation risk between groups (adjusted hazard risk [aHR]\u0026thinsp;=\u0026thinsp;0.58, 95% CI\u0026thinsp;=\u0026thinsp;0.40\u0026ndash;0.84, p\u0026thinsp;=\u0026thinsp;0.004), with a protective effect of PE versus not receiving PE (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Cox regression models, adjusted by relevant co-variables, confirmed this, showing lower hazards in the exposed group by comparison with their counterparts (aHR\u0026thinsp;=\u0026thinsp;0.29, 95% CI\u0026thinsp;=\u0026thinsp;0.18\u0026ndash;0.46, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Similarly, EBF at hospital discharge was associated with a decreased hazard of discontinuing EBF (aHR: 0.56, 95% CI: 0.33\u0026ndash;0.93, p\u0026thinsp;=\u0026thinsp;0.026). Other factors associated with cessation included public health facility delivery (aHR\u0026thinsp;=\u0026thinsp;4.19, 95% CI: 1.98\u0026ndash;8.82, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), primiparity (aHR: 1.83, 95% CI: 1.19\u0026ndash;2.83, p\u0026thinsp;=\u0026thinsp;0.006), depression at month four (aHR\u0026thinsp;=\u0026thinsp;2.06, 95% CI: 1.24\u0026ndash;3.41, p\u0026thinsp;=\u0026thinsp;0.005), specific reasons for stopping exclusive breastfeeding such as return to work (aHR: 6.30, 95% CI: 3.33\u0026ndash;11.93, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), healthcare provider recommendation to cease breastfeeding (aHR: 4.24, 95% CI: 2.30\u0026ndash;7.81, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), family advice (HR: 10.1, 95% CI: 4.69\u0026ndash;21.89, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and other negative breastfeeding experiences (aHR: 11.54, 95% CI: 3.71\u0026ndash;35.82, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were also found to increase the risk of discontinuation.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eEBF is crucial for infant health and development, but many mothers face challenges in maintaining it [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. PE can help promote EBF by preparing expectant mothers for potential barriers [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Our study found that PE can act as a protective factor against EBF abandonment, highlighting the importance of standardized PE programs for promoting EBF. Similar to other studies, PE has been found to have a positive impact on the EBF of women [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Prenatal breastfeeding education not only enhances women's knowledge but also fosters a positive attitude towards breastfeeding, which can lead to its continuation for an extended period [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In our study, participants who received PE showed higher education levels, better access to public health insurance, and more antenatal care visits, indicating potential disparities in healthcare access and utilization. This highlights the importance of PE as a crucial element of breastfeeding support interventions. However, some studies have presented contrasting results, indicating no influence of PE on EBF prevalence [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. It is important to note that diverse populations and geographic settings may contribute to these discrepancies, which can limit the generalizability of findings from this research to specific communities [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMaternal intention to breastfeed for six months or more was found to lower the risk of ceasing EBF, aligning with prior research indicating that intending EBF increases its duration [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. In contrast, a US cohort study revealed that although more participants in the post-intervention group expressed intentions for any BF and aimed for a year or longer compared to the pre-intervention group, no significant difference was found in EBF rates between the two cohorts [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEBF at hospital discharge, as observed in this study, is vital for prolonged BF aligning with the literature. Supplementing with commercial milk formula during hospital stays often leads to premature BF discontinuation, particularly among women from lower socioeconomic backgrounds [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe found that factors influencing early cessation of BF include delivery at a public health facility, maternal depression, and specific reasons for stopping breastfeeding. Public health facility delivery emerged as a significant predictor of breastfeeding discontinuation. In a study in Mexico healthcare professionals often recommend commercial milk formula despite recognizing breastfeeding benefits, influencing maternal choices [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn our study maternal depression significantly relates to early BF cessation. In the first month, depression incidence was twice as high in the non-prenatal education group, evening out by months four and six. The presence of maternal depression may contribute to decreased motivation and ability to initiate and sustain BF. Addressing maternal mental health through support and resources could mitigate its detrimental effect on BF [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOther specific reasons for stopping breastfeeding were also found in our study to influence early cessation, including insufficient milk supply, return to work, and healthcare provider recommendations to cease BF [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. These findings corroborate the importance of addressing individual barriers and challenges faced by mothers in their BF journey. Providing tailored support and resources to address these specific concerns could help mothers overcome obstacles and continue BF for longer durations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWe found that family advice and negative breastfeeding experiences were identified as additional factors contributing to early BF cessation. The influence of family and social support on BF decisions is crucial. Interventions promoting positive support and accurate BF information can create an environment conducive to BF success. Our study identified differences in the use of alternative products to replace BF between the exposed and unexposed groups. The unexposed group exhibited a higher prevalence of using breast milk substitutes and other milk alternatives, indicating a potential lack of support for EBF in this group. Notably, porridge emerged as the predominant substitute for EBF at six months, particularly among the unexposed group.\u003c/p\u003e \u003cp\u003eUnderstanding these factors is crucial for developing targeted interventions to support breastfeeding continuation. By addressing modifiable risk factors and providing adequate support, healthcare providers can help mothers overcome barriers to breastfeeding [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study findings show that there is an urgent need for action to support breastfeeding mothers and improve maternal and child health outcomes. To achieve this, comprehensive PE programs and BF support initiatives should be enhanced. Integrating BF education into routine prenatal care visits is essential, but it's important to recognize that limited healthcare setting hours and the availability of support groups may present barriers for some women. Additionally, exploring alternative educational settings can further reinforce the importance of BF practice. Lactation consultants and peer support groups should be made readily available to all mothers. Workplace policies should also be implemented to support BF mothers. Policymakers and healthcare providers can promote BF to improve maternal and child health outcomes and the overall well-being of families and communities.\u003c/p\u003e \u003cp\u003eStrengths of the study include its prospective design, a standardized intervention, robust statistical analysis, and inclusion of relevant covariates. These aspects enhance the validity and reliability of the findings.\u003c/p\u003e \u003cp\u003eIt is important to note that there are certain limitations to the study. One potential limitation is the presence of selection bias, meaning that the participants who chose to take part in the PE program could be more motivated than others; nevertheless, when searching for potential confounders during modeling it was possible to calculate reliable adjusted estimates of the risk of abandonment, minimizing the risk of selection bias. Additionally, the data collected for this study was self-reported, which may also have limitations, but the fact of collecting the information just after birth, and corroborating the data by exploding the clinical records reduced the risk of information bias.\u003c/p\u003e \u003cp\u003eAreas for future research include investigating the long-term effects of PE on BF outcomes, how and to what extent education courses should be, and exploring the cultural and contextual factors that influence BF practices. A clinical trial and a methodology that fits the local context are steps that can be taken for new research in this field.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study shows that PE independently and significantly increases the duration of EBF. Integrating PE into prenatal care can bolster support for BF mothers. Tailored strategies addressing factors like delivery setting, maternal depression, and reason for cessation are important covariates. Evidence-based intervention, including adherence to the International Code of Marketing of Breast-milk Substitutes, lactation support, postpartum depression screening, and workplace policies are essential for fostering a supportive BF environment and improving maternal and child health outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eBF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eBreastfeeding\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEBF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eExclusive breastfeeding\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHazard Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePPD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePost partum depression\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePrenatal Education\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStandard Deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research protocol was approved by the Institutional Research Ethics Committee (CIEI-Human) of the Universidad Peruana Cayetano Heredia (Certificate 093-05-17 dated February 17, 2017) and by the Ethics Committee for Research in Human Subjects of the Pontifical Catholic University of Ecuador (Letter CEISH-736-2019 dated April 30, 2019). Informed consent was obtained from all participants before enrollment under the Declaration of Helsinki. Measures were taken to ensure participant confidentiality and privacy throughout the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAvailability of Data and Materials: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s) received no specific funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: BT, HH.; Methodology: BT, HH; Formal analysis: BT, HH, ID-E, ET; Writing - original draft preparation: BT.; Writing - review and editing: BT, HH, ID-D, ET.; Supervision: HH, ID-E. All authors contributed to the article and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to express our gratitude to Dr. Oswaldo V\u0026aacute;sconez, Dr. C\u0026eacute;sar Carrillo, Dr. Edison Ch\u0026aacute;vez, Dr. Luis Su\u0026aacute;rez, Dr. Juan Panchi, Dr. Jorge Pe\u0026ntilde;aherrera, Dr. Andr\u0026eacute;s Sotomayor, Dr. Carlos Tello Ponce, Dra. Luciana Armijos, Dra. Ana Villacr\u0026eacute;s, Dra. Piedad Villac\u0026iacute;s, MSc. Esteban Zapata, Dra. Sabrina Morales, Dra. Klaudia Wolff, Dr. Rodrigo Henr\u0026iacute;quez and Dr. Pedro Saona. We would also like to thank the individuals in the health care settings who helped us promote the survey advertisements and the women who invested their time in completing the survey.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eLyons KE, Ryan CA, Dempsey EM, Ross RP, Stanton C. Breast milk, a source of beneficial microbes and associated benefits for infant health. Nutrients. 2020;12:1\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491\u0026ndash;504.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBoccolini CS, Lacerda EMDA, Bertoni N, Oliveira N, Alves-Santos NH, Farias DR, et al. Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets. BMJ Glob Heal. 2023;8:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth. 2023;23:1\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOggero MK, Rozmus CL, LoBiondo-Wood G. Effects of Prenatal Breastfeeding Education on Breastfeeding Duration Beyond 12 Weeks: A Systematic Review. Heal Educ Behav. 2024. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/10901981231220668\u003c/span\u003e\u003cspan address=\"10.1177/10901981231220668\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLumbiganon P, Martis R, Laopaiboon M, Festin MR, Ho JJ, Hakimi M. Antenatal breastfeeding education for increasing breastfeeding duration. Cochrane Database Syst Rev. 2016. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/14651858.CD006425.pub4\u003c/span\u003e\u003cspan address=\"10.1002/14651858.CD006425.pub4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKehinde J, O\u0026rsquo;Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023;118.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInstituto Nacional de Estad\u0026iacute;sticas y Censos. Mujeres y hombres del Ecuador en cifras III. Serie inform\u0026aacute;tica estrat\u0026eacute;gica. INEC. 2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMarrugat J. Calculadora de Grand\u0026agrave;ria Mostral GRANMO versi\u0026oacute; 7.12. Institut Municipal D\u0026rsquo;investigaci\u0026oacute; M\u0026egrave;dica. Institut de Rercerca Hospital del Mar; 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFreire W, Ram\u0026iacute;rez MJ, Belmont P, Mendieta MJ, Silva K, Romero N et al. Resumen Ejecutivo. Tomo I. Encuesta Nacional de Salud y Nutrici\u0026oacute;n. ENSANUT-ECU 2011\u0026ndash;2013. Primera. Quito Ecuador; 2013.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSantos IS, Tavares BF, Munhoz TN, Manzolli P, De \u0026Aacute;vila GB, Jannke E, et al. Patient health questionnaire-9 versus Edinburgh postnatal depression scale in screening for major depressive episodes: A cross-sectional population-based study. BMC Res Notes. 2016;9:4\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eACOG. Screening for perinatal depression. Replace Comm Opin. 2018;132:208\u0026ndash;12.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGarc\u0026iacute;a Alarc\u0026oacute;n RE. Lactancia: derecho garantizado en el sistema jur\u0026iacute;dico ecuatoriano. Una mirada desde el enfoque de g\u0026eacute;nero y la doctrina de protecci\u0026oacute;n integral de la ni\u0026ntilde;ez. Rev la Fac Derecho y Ciencias Pol\u0026iacute;ticas. 2019;49:327\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganizaci\u0026oacute;n Mundial de la Salud. Indicadores para evaluar las pr\u0026aacute;cticas de alimentaci\u0026oacute;n del lactante y del ni\u0026ntilde;o peque\u0026ntilde;o. Parte 1 Definiciones. Conclusiones de la reuni\u0026oacute;n de consenso llevada a cabo del 6 al 8 de noviembre de 2007 en Washington, DC, EE.UU. Primera. Washington D.C.; 2009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. United Nations Childrens\u0026rsquo;s Fund. Indicators for assessing infant and young child feeding practices: definitions and measurement methods. Geneva; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGiang HTN, Duy DTT, Vuong NL, Ngoc NTT, Pham TT, Duc NTM, et al. Prevalence of exclusive breastfeeding for the first six months of an infant\u0026rsquo;s life and associated factors in a low\u0026ndash;middle income country. Int Breastfeed J. 2023;18:1\u0026ndash;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShafaei FS, Mirghafourvand M, Havizari S. The effect of prenatal counseling on breastfeeding self-efficacy and frequency of breastfeeding problems in mothers with previous unsuccessful breastfeeding: A randomized controlled clinical trial. BMC Womens Health. 2020;20:1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerwick M, Louis-Jacques AF. Prenatal Counseling and Preparation for Breastfeeding. Obstet Gynecol Clin North Am. 2023;50:549\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJacobsen N. Antenatal breastfeeding education and support summary and analysis of 2 cochrane publications. J Perinat Neonatal Nurs. 2018;32:144\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWu Q, Tang N, Wacharasin C. Factors influencing exclusive breastfeeding for 6 months postpartum: A systematic review. Int J Nurs Knowl 2022; August 2021:1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosen-Carole C, Halterman J, Baldwin CD, Martin H, Goldstein NPN, Allen K, et al. Prenatal Provider Breastfeeding Toolkit: Results of a Pilot to Increase Women\u0026rsquo;s Prenatal Breastfeeding Support, Intentions, and Outcomes. J Hum Lact. 2022;38:64\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVehling L, Chan D, McGavock J, Becker AB, Subbarao P, Moraes TJ, et al. Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity. Birth. 2018;45:440\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHern\u0026aacute;ndez-Cordero S, Vilar-Compte M, Tomori C, Lara-Mej\u0026iacute;a V, Rovelo-Vel\u0026aacute;zquez N, Hayes K et al. Healthcare professionals and commercial milk formula recommendations in the urban Mexican context. Front Public Heal. 2023;11.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHern\u0026aacute;ndez-Cordero S, P\u0026eacute;rez-Escamilla R. What will it take to increase breastfeeding? Matern Child Nutr. 2022;18:1\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Exclusive breastfeeding, postpartum depression, prenatal education, public health practice, maternal health","lastPublishedDoi":"10.21203/rs.3.rs-4493713/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4493713/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Breast milk is the optimal food for humans, however, many mothers encounter difficulties sustaining exclusive breastfeeding (EBF). Prenatal education (PE) has been suggested as a potential strategy to promote EBF. There remains a gap in understanding how PE influences EBF duration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eThis prospective cohort study aimed to evaluate the effect of PE on EBF continuation among mothers who gave birth in private and public hospitals in Quito, Ecuador. A total of 278 participants were recruited, with 152 receiving PE and 126 not receiving it. Data was collected through structured surveys. Baseline clinical information was obtained through face-to-face interviews conducted after delivery and before discharge. Then, follow-up telephone interviews were conducted at one, four, and six months postpartum.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eComparisons between the exposed (PE) and unexposed groups revealed significant differences in education level, health insurance, antenatal care visits, rooming-in rates, parity, and maternal breastfeeding (BF) intentions. Participants who received PE demonstrated a significantly longer mean duration of EBF compared to those who did not (89.4 ± 77.2 days vs. 66.1 ± 70.2 days, p = 0.004). The incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. Cox survival analysis indicated a lower risk of EBF cessation among mothers who received PE (adjusted hazard ratio [aHR] = 0.58, 95% CI = 0.40-0.84, p = 0.004). Other factors associated with EBF discontinuation included delivery at a public health facility, postpartum depression, specific reasons for stopping BF, insufficient supply, return to work, healthcare provider recommendations, family advice, and negative BF experiences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eStandardized PE programs have a significant and independent positive impact on EBF duration among mothers in Quito, Ecuador. These findings underscore the importance of integrating PE into routine prenatal care and providing comprehensive postpartum support to promote BF continuation. It is necessary to develop targeted interventions to address modifiable risk factors for BF cessation.\u003c/p\u003e","manuscriptTitle":"The effect of prenatal education on exclusive breastfeeding among women in Quito. Prospective cohort study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-13 20:59:59","doi":"10.21203/rs.3.rs-4493713/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-18T08:46:27+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-05T05:36:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180587170332839588641944006782516036976","date":"2025-02-27T13:40:46+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-08-06T13:13:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"91074073252046574044964269841072091755","date":"2024-08-05T19:32:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"103293432632006595689289392680143533440","date":"2024-07-26T12:45:44+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-17T05:54:19+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-05-31T10:55:01+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-31T02:44:01+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-31T02:44:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Pregnancy and Childbirth","date":"2024-05-29T02:15:40+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-pregnancy-and-childbirth","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"prch","sideBox":"Learn more about [BMC Pregnancy and Childbirth](http://bmcpregnancychildbirth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/prch/default.aspx","title":"BMC Pregnancy and Childbirth","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f421ff68-1c04-4a02-99dc-eea4f9eb3665","owner":[],"postedDate":"June 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-05-05T15:59:31+00:00","versionOfRecord":{"articleIdentity":"rs-4493713","link":"https://doi.org/10.1186/s12884-025-07651-8","journal":{"identity":"bmc-pregnancy-and-childbirth","isVorOnly":false,"title":"BMC Pregnancy and Childbirth"},"publishedOn":"2025-05-02 15:56:59","publishedOnDateReadable":"May 2nd, 2025"},"versionCreatedAt":"2024-06-13 20:59:59","video":"","vorDoi":"10.1186/s12884-025-07651-8","vorDoiUrl":"https://doi.org/10.1186/s12884-025-07651-8","workflowStages":[]},"version":"v1","identity":"rs-4493713","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4493713","identity":"rs-4493713","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}