Factors Affecting Exclusive Breastfeeding, Using Adaptive LASSO Regression

Background: exclusive breastfeeding (ebf) in the first six months of the life can significantly improve maternal and children health, and it is especially important in low- and middle-income countries. we aimed to determine the factors affecting ebf duration in a sample of iranian infants. methods: this prospective study was conducted between april 2012 and october 2014 in fars, iran. women (n=2640), who had given birth to healthy term infants were categorized into ebf versus non-ebf groups. demographic information from mothers and infants, medical and drug history, and pregnancy related factors were compared between the two groups. multivariable analysis was performed using adaptive lasso regression. p<0.05 was considered significant. results: the mean duration of ebf was 4.63±1.99 months. there was an inverse association between the mother’s educational level and duration of ebf (p<0.001). also, we found that mothers who were housewives had a significantly longer duration of ebf (4.68±1.97) compared to mothers with either part-time (4.21±2.01) or full-time jobs (4.02±2.12) (p<0.001). by eliminating the redundant factors, the proposed multivariable model showed the infant’s weight gain during ebf, singleton/multiple pregnancies, maternal perception of quantity of breast milk, post-partum infection, use of pacifier, neonate’s irritability, birth place and mother’s full-time job as the most important factors affecting the duration of ebf. twin pregnancies, post-partum infection, cesarean section by maternal request, use of a pacifier and irritability in the neonatal period significantly reduced the duration of ebf. conclusion: health policy-makers should promote ebf programs among the educated as well as working mothers in order to positively affect the community’s health status.