A study of 190 mothers of firstborn, 6 month-old infants showed that different mechanisms affect onset and duration of breast feeding. Maternal education is related both to onset and duration of breast feeding; more highly educated women begin breast feeding and they breast feed for a longer period. Type of delivery is significantly associated with onset of breast feeding, even when controlling for educational level: cesarean delivered women are less likely to begin breast feeding than mothers delivered vaginally, although once breast feeding has begun, type of delivery no longer plays any role. Smoking is associated only with duration of breast feeding and not with onset. Among those women who breast feed for a long period, all are non-smokers. Women usually do not resume smoking immediately after giving birth which may explain why smoking is associated only with duration and not with onset of breast feeding. The results suggest the importance of influencing mothers so they do not resume or, at least, delay resumption of smoking as long as possible after parturition, in order to increase the likelihood of breast feeding. Caesarean delivered women should be encouraged to begin breast feeding while still in hospital.
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