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Breastfeed Med. 2011 Dec;6(6):385-91. doi: 10.1089/bfm.2010.0076. Epub 2011 Jan 21.

Longer previous smoking abstinence relates to successful breastfeeding initiation among underserved smokers.

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Department of Public Health, Temple University, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122, USA.



The purpose of this study was to examine sociodemographic and behavioral factors related to successful breastfeeding initiation among medically underserved maternal smokers-a population with persistently low rates of initiation.


Pretreatment data from a larger randomized behavioral counseling, secondhand smoke reduction trial was examined for this study. Maternal smokers with babies younger than 4 years old reported breastfeeding behaviors. Mothers who breastfed for >4 weeks (n = 50) were matched with mothers who never initiated breastfeeding based on infant age, gender, and maternal race. Multinomial logistic regression analysis tested the hypothesis that a greater duration of mothers' longest previous smoking abstinence would predict successful breastfeeding initiation in the context of other sociodemographic and behavioral factors known to relate to breastfeeding (e.g., education level, income, and maternal age).


The sample consisted of current maternal smokers with a mean age of 28.8 ± 7.1 years. Among participants, 94% were African American, 81% were single, 63% reported an annual family income less than $15,000, and 76% had completed a high school education or less. Logistic regression demonstrated that a longer duration of previous smoking abstinence and education beyond high school predicted breastfeeding initiation.


Maternal smokers' previous success at smoking abstinence may increase the likelihood of successful breastfeeding initiation. To improve prenatal health education for maternal smokers with low education levels, researchers should explore the utility of merging smoking cessation and postpartum relapse prevention advice within the context of lactation counseling to maximize success of smokers' efforts to initiate breastfeeding.

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