Associations of childcare-type, childcare-timing, and childcare-based breastfeeding support with breastfeeding duration

BACKGROUND Exclusive breastfeeding during the first six months of life and breastfeeding with complementary foods thereafter is recommended by health organizations. Studies demonstrate breastfeeding is associated with a mother's return to work and childcare arrangements. Limited studies exist allowing for time-varying childcare arrangements vis-à-vis breastfeeding. This study addresses this gap by modeling time-dependent exposure to: various types of childcare and the breastfeeding support childcare provides. METHODS We use data from the national Infant Feeding Practices Study II (IFPS2). The IFPS2 is a prospective study that followed mother-child dyads from the third trimester to one year postpartum. Our four outcome variables of interest are time until cessation of: 1) any human milk feeding, 2) exclusive human milk feeding, 3) any breastfeeding at the breast, and 4) exclusive breastfeeding at the breast. The exposure variables of interest are: 1) the type and timing of childcare and childcare-based breastfeeding support; and 2) a delay in return to work measured against prenatal intention. Survival analyses are employed. A Complementary Log-Log Model accommodates 1) interval censoring and 2) time-dependent exposure variables. RESULTS The results of this study will provide insight on how variations in the type, timing, and breastfeeding supportiveness of childcare are associated with four types of breastfeeding duration. CONCLUSIONS These results may inform parental decisions related to childcare. This study may also inform efforts to improve childcare-based breastfeeding support by first identifying effective types of support and second identifying the time when that support is most crucial to breastfeeding success.