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Maternal, Infant Characteristics, Breastfeeding Techniques, and Initiation: Structural Equation Modeling Approaches.

Lau Y, Htun TP, Lim PI, Ho-Lim S, Klainin-Yobas P - PLoS ONE (2015)

Bottom Line: However, breastfeeding techniques were not significantly associated with exclusive breastfeeding initiation in the cesarean section group.Maternal age, maternal race, gestations, birth weight of infant, and postnatal complications had no significant impacts on breastfeeding techniques or exclusive breastfeeding initiation in our study.This relationship implies the importance of early effective interventions among first-time mothers with jaundice infants in improving breastfeeding techniques and promoting exclusive breastfeeding initiation.

View Article: PubMed Central - PubMed

Affiliation: Department of Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

ABSTRACT

Objectives: The aim of this study was to examine the relationships among maternal and infant characteristics, breastfeeding techniques, and exclusive breastfeeding initiation in different modes of birth using structural equation modeling approaches.

Methods: We examined a hypothetical model based on integrating concepts of a breastfeeding decision-making model, a breastfeeding initiation model, and a social cognitive theory among 952 mother-infant dyads. The LATCH breastfeeding assessment tool was used to evaluate breastfeeding techniques and two infant feeding categories were used (exclusive and non-exclusive breastfeeding).

Results: Structural equation models (SEM) showed that multiparity was significantly positively associated with breastfeeding techniques and the jaundice of an infant was significantly negatively related to exclusive breastfeeding initiation. A multigroup analysis in the SEM showed no difference between the caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation. Breastfeeding techniques were significantly positively associated with exclusive breastfeeding initiation in the entire sample and in the vaginal deliveries group. However, breastfeeding techniques were not significantly associated with exclusive breastfeeding initiation in the cesarean section group. Maternal age, maternal race, gestations, birth weight of infant, and postnatal complications had no significant impacts on breastfeeding techniques or exclusive breastfeeding initiation in our study. Overall, the models fitted the data satisfactorily (GFI = 0.979-0.987; AGFI = 0.951-0.962; IFI = 0.958-0.962; CFI = 0.955-0.960, and RMSEA = 0.029-0.034).

Conclusions: Multiparity and jaundice of an infant were found to affect breastfeeding technique and exclusive breastfeeding initiation respectively. Breastfeeding technique was related to exclusive breastfeeding initiation according to the mode of birth. This relationship implies the importance of early effective interventions among first-time mothers with jaundice infants in improving breastfeeding techniques and promoting exclusive breastfeeding initiation.

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Multigroup analysis in the SEM among vaginal delivery group (n = 699).
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pone.0142861.g004: Multigroup analysis in the SEM among vaginal delivery group (n = 699).

Mentions: The multigroup analysis tested critical ratio for differences between caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation (Figs 3 and 4). Postnatal complications were not included in the multigroup analysis because sample size was not big enough for the SEM analysis in each separate group. The result of the C.R. for differences between caesarean section and vaginal delivery in this study was -1.429, so there was no difference between caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation. Overall, the model fitted the data satisfactorily (GFI = 0.979, AGFI = 0.951, IFI = 0.962, CFI = 0.960, and RMSEA = 0.029). Multiparity was significantly positively associated with breastfeeding technique in the cesarean section group (β = 0.26, P < 0.01) and vaginal delivery group (β = 0.11, P < 0.05). Jaundice of an infant was significantly negatively associated with exclusive breastfeeding initiation in the cesarean section group (β = -0.19, P < 0.01) and vaginal delivery group (β = -0.21, P < 0.001). Breastfeeding technique was significantly positively associated with exclusive breastfeeding initiation in the vaginal delivery group (β = 0.19, P < 0.001) but not in the cesarean section group (β = 0.01, P > 0.05). All factor loadings (λ) for breastfeeding techniques ranged from 0.30 to 0.77 in these two SEMs. These results can be interpreted as a demonstration that the multiparity and jaundice of an infant are consistent factors for breastfeeding techniques and exclusive breastfeeding initiation respectively. The relationships between breastfeeding techniques and exclusive breastfeeding initiation are different between the cesarean section and vaginal delivery groups. However, maternal age, maternal race, gestation, and birth weight of infants had no significant impacts (P > 0.05) on breastfeeding techniques or exclusive breastfeeding initiation in the cesarean section and vaginal delivery groups.


Maternal, Infant Characteristics, Breastfeeding Techniques, and Initiation: Structural Equation Modeling Approaches.

Lau Y, Htun TP, Lim PI, Ho-Lim S, Klainin-Yobas P - PLoS ONE (2015)

Multigroup analysis in the SEM among vaginal delivery group (n = 699).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643938&req=5

pone.0142861.g004: Multigroup analysis in the SEM among vaginal delivery group (n = 699).
Mentions: The multigroup analysis tested critical ratio for differences between caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation (Figs 3 and 4). Postnatal complications were not included in the multigroup analysis because sample size was not big enough for the SEM analysis in each separate group. The result of the C.R. for differences between caesarean section and vaginal delivery in this study was -1.429, so there was no difference between caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation. Overall, the model fitted the data satisfactorily (GFI = 0.979, AGFI = 0.951, IFI = 0.962, CFI = 0.960, and RMSEA = 0.029). Multiparity was significantly positively associated with breastfeeding technique in the cesarean section group (β = 0.26, P < 0.01) and vaginal delivery group (β = 0.11, P < 0.05). Jaundice of an infant was significantly negatively associated with exclusive breastfeeding initiation in the cesarean section group (β = -0.19, P < 0.01) and vaginal delivery group (β = -0.21, P < 0.001). Breastfeeding technique was significantly positively associated with exclusive breastfeeding initiation in the vaginal delivery group (β = 0.19, P < 0.001) but not in the cesarean section group (β = 0.01, P > 0.05). All factor loadings (λ) for breastfeeding techniques ranged from 0.30 to 0.77 in these two SEMs. These results can be interpreted as a demonstration that the multiparity and jaundice of an infant are consistent factors for breastfeeding techniques and exclusive breastfeeding initiation respectively. The relationships between breastfeeding techniques and exclusive breastfeeding initiation are different between the cesarean section and vaginal delivery groups. However, maternal age, maternal race, gestation, and birth weight of infants had no significant impacts (P > 0.05) on breastfeeding techniques or exclusive breastfeeding initiation in the cesarean section and vaginal delivery groups.

Bottom Line: However, breastfeeding techniques were not significantly associated with exclusive breastfeeding initiation in the cesarean section group.Maternal age, maternal race, gestations, birth weight of infant, and postnatal complications had no significant impacts on breastfeeding techniques or exclusive breastfeeding initiation in our study.This relationship implies the importance of early effective interventions among first-time mothers with jaundice infants in improving breastfeeding techniques and promoting exclusive breastfeeding initiation.

View Article: PubMed Central - PubMed

Affiliation: Department of Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

ABSTRACT

Objectives: The aim of this study was to examine the relationships among maternal and infant characteristics, breastfeeding techniques, and exclusive breastfeeding initiation in different modes of birth using structural equation modeling approaches.

Methods: We examined a hypothetical model based on integrating concepts of a breastfeeding decision-making model, a breastfeeding initiation model, and a social cognitive theory among 952 mother-infant dyads. The LATCH breastfeeding assessment tool was used to evaluate breastfeeding techniques and two infant feeding categories were used (exclusive and non-exclusive breastfeeding).

Results: Structural equation models (SEM) showed that multiparity was significantly positively associated with breastfeeding techniques and the jaundice of an infant was significantly negatively related to exclusive breastfeeding initiation. A multigroup analysis in the SEM showed no difference between the caesarean section and vaginal delivery groups estimates of breastfeeding techniques on exclusive breastfeeding initiation. Breastfeeding techniques were significantly positively associated with exclusive breastfeeding initiation in the entire sample and in the vaginal deliveries group. However, breastfeeding techniques were not significantly associated with exclusive breastfeeding initiation in the cesarean section group. Maternal age, maternal race, gestations, birth weight of infant, and postnatal complications had no significant impacts on breastfeeding techniques or exclusive breastfeeding initiation in our study. Overall, the models fitted the data satisfactorily (GFI = 0.979-0.987; AGFI = 0.951-0.962; IFI = 0.958-0.962; CFI = 0.955-0.960, and RMSEA = 0.029-0.034).

Conclusions: Multiparity and jaundice of an infant were found to affect breastfeeding technique and exclusive breastfeeding initiation respectively. Breastfeeding technique was related to exclusive breastfeeding initiation according to the mode of birth. This relationship implies the importance of early effective interventions among first-time mothers with jaundice infants in improving breastfeeding techniques and promoting exclusive breastfeeding initiation.

Show MeSH
Related in: MedlinePlus