Prenatal Feeding Intentions among Low Income Smoke Exposed Women

Background: Previous literature indicates that socio-demographic differences in breastfeeding initiation and duration may be mediated by prenatal feeding intentions. The objective of this study was to describe change in and predictors of prenatal breastfeeding intentions during the course of pregnancy among smoke exposed women. Methods: Low-income, adult women (n=271) participating in a smoking avoidance study (non-intervention group)were interviewed during the 16th and 32nd weeks of pregnancy and queried about feeding intentions and breastfeeding knowledge, attitudes, and self-efficacy (KAS) . Differences between measures obtained at 16 weeks and 32 weeks were assessed. Multivariable models were used to examine predictors of a breastfeeding index KAS, as well as breastfeeding intention during the 32nd week of pregnancy. Results: Mean KAS increased significantly between the 16th and 32nd week of pregnancy (37.89 and 39.06, respectively; p>0.0002). There were no differences in KAS by age, race/ethnicity, or education at either time point. A greater proportion of expectant mothers reported an intention to breastfeed at 32 weeks (57.4%) as compared to 16 weeks ( 47.2%) ( p<0.05). Women who reported an intention to breastfeed at 32 weeks were more likely to have a higher KAS, have fewer members in their household, and to have quit or paused smoking since becoming pregnant. Conclusions: Results indicate that smoke exposed women's decision making process is somewhat fluid during pregnancy. To support the American Academy of Pediatrics Guidelines that smoking and smoke exposed women should breastfeed, interventions should aim to improve breastfeeding knowledge and self-efficacy among smoke exposed women.