Background: In Italy, there is no widespread standardized national monitoring system for breastfeeding practices.
Research aims: To estimate breastfeeding indicators according to World Health Organization recommendations and associated socioeconomic factors, highlighting the potential and limitations of vaccination centers as sources of data.
Methods: A cross-sectional study was conducted in the vaccination centers of 13 Local Health Districts in Italy. Data on breastfeeding practices were collected via structured questionnaires between February and November, 2015, from 14,191 mothers recruited during vaccination appointments for the 1st, 2nd and 3rd doses against Diphtheria, Tetanus, and Pertussis, and for the 1st dose against Measles, Mumps, and Rubella. Crude breastfeeding rates and direct age standardized rates were compared. Logistic regression models were used to explore socio-demographic characteristics associated with breastfeeding indicators.
Results: Overall, 14,191 mothers were recruited, with a response rate higher than 94%. Exclusive breastfeeding rates among children aged 2-3 months and 4-5 months were 44.4% and 25.8%, respectively; breastfeeding rates among children aged 11-12 and 13-15 months were 34.2% and 24.9%; 10.4% never breastfed. Strong geographical and socioeconomic differences were found. Some differences also emerged between crude and standardized rates.
Conclusions: We conclude that a survey system in vaccination centers is practicable and its use could produce, with standardized methodology, representative regional and national breastfeeding estimates that could monitor progress towards present and future targets.
Keywords: breastfeeding; breastfeeding rates; epidemiological methods.