{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:49Z","timestamp":1787017069720,"version":"build-2736575974"},"reference-count":35,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2019,2,19]]},"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Given the support for the numerous benefits of breastfeeding, a better understanding of social and health determinants is necessary, particularly in under-researched populations. We examined determinants of breastfeeding initiation and duration using a national cohort of Chilean mothers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Participants included 13\u2009738 families enrolled in the Encuesta Longitudinal de la Primera Infancia cohort. Data were collected in 2010 and 2012. Families from all regions of the country were considered. Breastfeeding information was collected via maternal report and standardised assessments were used to collect information on maternal IQ and personality. Logistic and linear regressions were used to identify predictors of breastfeeding initiation and duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Breastfeeding was initiated by 95.2% of mothers. Variation in duration of breastfeeding was large, ranging from 1 to 48 months (M = 11.74; SD = 8.74). Maternal IQ, low-risk prenatal behaviours, conditions at birth and the presence of a partner were relevant predictors of both initiation and duration of breastfeeding, whereas personality and contextual\/socioeconomic factors were relevant only for breastfeeding duration. Differences between regions were observed. Rates of caesarean deliveries are alarmingly high and triple that of the global WHO recommendations, at 45% of deliveries in Chile, which are implicated in both initiation and duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Breastfeeding rates exceed Chilean target goals although vary by region. Global targets now need to be focused on. Social and health determinants are implicated in both initiation and duration of breastfeeding. These findings suggest important targets for policy development and breastfeeding initiatives in Chile, particularly concerning the reduction of surgical deliveries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2018-211148","type":"journal-article","created":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T17:15:30Z","timestamp":1552497330000},"page":"637-644","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Breastfeeding initiation and duration in Chile: understanding the social and health determinants"],"prefix":"10.1136","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0438-9354","authenticated-orcid":false,"given":"Chamarrita","family":"Farkas","sequence":"first","affiliation":[{"name":"Psychology School, Pontificia Universidad Catolica de Chile, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa-Christine","family":"Girard","sequence":"additional","affiliation":[{"name":"Department of Clinical Psychology, University of Edinburgh School of Health in Social Science, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,13]]},"reference":[{"key":"2025100305531178000_73.7.637.1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13133"},{"key":"2025100305531178000_73.7.637.2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2009.0050"},{"key":"2025100305531178000_73.7.637.3","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2005.10719480"},{"key":"2025100305531178000_73.7.637.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)01024-7"},{"key":"2025100305531178000_73.7.637.5","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1001\/jamapediatrics.2013.455","article-title":"Infant feeding and childhood cognition at ages 3 and 7 years: effects of breastfeeding duration and exclusivity","volume":"167","author":"Belfort","year":"2013","journal-title":"JAMA Pediatr"},{"key":"2025100305531178000_73.7.637.6","first-page":"1","article-title":"Breastfeeding and later cognitive and academic outcomes","volume":"101","author":"Horwood","year":"1988","journal-title":"Pediatrics"},{"key":"2025100305531178000_73.7.637.7","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.65.5.578"},{"key":"2025100305531178000_73.7.637.8","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-202500"},{"key":"2025100305531178000_73.7.637.9","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-012-1182-9"},{"key":"2025100305531178000_73.7.637.10","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-1848","article-title":"Breastfeeding, cognitive and noncognitive development in early childhood: a population study","volume":"139","author":"Girard","year":"2017","journal-title":"Pediatrics"},{"key":"2025100305531178000_73.7.637.11","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1007\/s00787-017-1085-9","article-title":"Breastfeeding and externalising problems: a quasi-experimental design with a national cohort","volume":"27","author":"Girard","year":"2018","journal-title":"Eur Child Adolesc Psychiatry"},{"key":"2025100305531178000_73.7.637.12","unstructured":"World Health Organization, UNICEF . Global nutrition targets 2025. Breastfeeding Policy Brief. WHO\/NMH\/NHD\/14, 2014. Available: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/149022\/WHO_NMH_NHD_14.7_eng.pdf;jsessionid=AF520444A1E7A20F648B9708A52FE9E8?sequence=1"},{"key":"2025100305531178000_73.7.637.13","unstructured":"Vio F , Weis-staub G , Atalah E , et al . La desnutrici\u00f3n infantil en Chile: Pol\u00edticas y programas que explican su erradicaci\u00f3n [Child malnutrition in Chile: Policies and programs that explain its eradication]. Regional Technical Conference \u201chacia la erradicaci\u00f3n de la desnutrici\u00f3n infantil en Am\u00e9rica Latina y el Caribe\u201d, 2008. Available: http:\/\/www.bvsde.ops-oms.org\/texcom\/nutricion\/LOW\/LOW-2a.pdf"},{"key":"2025100305531178000_73.7.637.14","doi-asserted-by":"crossref","first-page":"76","DOI":"10.7764\/Horiz_Enferm.24.1.76","article-title":"Reflexi\u00f3n de la lactancia materna en Chile [Reflexion of breastfeeding in Chile]","volume":"24","author":"N\u00fa\u00f1ez","year":"2013","journal-title":"Horiz Enferm"},{"key":"2025100305531178000_73.7.637.15","doi-asserted-by":"crossref","unstructured":"Atalah E . Situaci\u00f3n actual de la lactancia en Chile [Current status of breastfeeding in Chile]. Medwave 2006;6.","DOI":"10.5867\/medwave.2006.05.3528"},{"key":"2025100305531178000_73.7.637.16","unstructured":"UNICEF . Estado mundial de la infancia 2014 en cifras [World state of infancy 2014 in numbers], 2014. Available: https:\/\/www.unicef.org\/spanish\/sowc2014\/numbers\/"},{"key":"2025100305531178000_73.7.637.17","first-page":"12","article-title":"Factores que influyen en la disminuci\u00f3n de lactancia materna exclusiva hasta los 6 meses de vida: Revisi\u00f3n tem\u00e1tica y contexto en Chile [Factors that influence the decrease in exclusive breastfeeding until 6 months of age: Thematic review and context in Chile]","volume":"1","author":"Valenzuela Galleguillos","year":"2016","journal-title":"Rev Intern Salud Materno Fetal"},{"key":"2025100305531178000_73.7.637.18","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2431-9-66","article-title":"The relationship of bottle feeding and other sucking behaviors with speech disorder in Patagonian preschoolers","volume":"9","author":"Barbosa","year":"2009","journal-title":"BMC Pediatr"},{"key":"2025100305531178000_73.7.637.19","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4067\/S0717-75182013000100008","article-title":"Factores que inciden en la duraci\u00f3n de la lactancia materna exclusiva en una comunidad rural de Chile [Factor affecting the duration of exclusiv breastfeeding in a rural community of Chile]","volume":"40","author":"Pino","year":"2013","journal-title":"Rev Chil Nutrici\u00f3n"},{"key":"2025100305531178000_73.7.637.20","doi-asserted-by":"crossref","first-page":"161","DOI":"10.4067\/S0370-41062012000200007","article-title":"Factores asociados a la lactancia materna exclusiva [Factors associated to exclusive maternal breastfeeding]","volume":"83","author":"Ni\u00f1o","year":"2012","journal-title":"Rev Chil de Pediatr\u00eda"},{"key":"2025100305531178000_73.7.637.21","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2002.tb00019.x"},{"key":"2025100305531178000_73.7.637.22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0166946","article-title":"Factors associated with breastfeeding initiation: a comparison between France and French-speaking Canada","volume":"11","author":"Girard","year":"2016","journal-title":"PLoS One"},{"key":"2025100305531178000_73.7.637.23","unstructured":"Encuesta Longitudinal de la Primera Infancia (ELPI) . Produced and distributed by the Microdata center, economics. Santiago de Chile, Chile: Department, Universidad de Chile."},{"key":"2025100305531178000_73.7.637.24","doi-asserted-by":"crossref","unstructured":"Wechsler D . The Measurement of Adult Intelligence. Baltimore, MD: William and Wilkins, 1939.","DOI":"10.1037\/10020-000"},{"key":"2025100305531178000_73.7.637.25","unstructured":"Hermosilla M . La Escala de Inteligencia de Wechsler para adultos [Wechsler intelligence scale for adults]. Santiago, Chile: Escuela de Psicolog\u00eda, Pontificia Universidad Cat\u00f3lica de Chile, 1982."},{"key":"2025100305531178000_73.7.637.26","unstructured":"Berdicewski O , Herreros R . Normas de adaptaci\u00f3n WAIS a Chile [WAIS adaptation norms to Chile]. Santiago, Chile: Universidad de Chile, 1960."},{"key":"2025100305531178000_73.7.637.27","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.48.1.26"},{"key":"2025100305531178000_73.7.637.28","unstructured":"Casullo M . Big five inventory. Buenos Aires, Argentina: Universidad de Buenos Aires, 2000."},{"key":"2025100305531178000_73.7.637.29","unstructured":"World Health Organisation . Early initiation of breastfeeding to promote exclusive breastfeeding, 2018, 2018. Available: http:\/\/www.who.int\/elena\/titles\/early_breastfeeding\/en\/"},{"key":"2025100305531178000_73.7.637.30","article-title":"Early skin-to-skin contact for mothers and their healthy newborn infants","volume":"11","author":"Moore","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025100305531178000_73.7.637.31","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/68.2.335"},{"key":"2025100305531178000_73.7.637.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(99)00109-1"},{"key":"2025100305531178000_73.7.637.33","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1079\/PHN2001164","article-title":"Breastfeeding determinants and a suggested framework for action in Europe","volume":"4","author":"Yngve","year":"2001","journal-title":"Public Health Nutr"},{"key":"2025100305531178000_73.7.637.34","unstructured":"WHO Statement on Caesarean Section Rates . World Health Organization, WHO & Human reproduction Programme, HRP (WHO\/RHR\/15.02), 2015. Available: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/161442\/WHO_RHR_15.02_eng.pdf;jsessionid=5CE467D0F755B6F176F6DD42866BE840?sequence=1"},{"key":"2025100305531178000_73.7.637.35","unstructured":"World Health Organization,, UNICEF . Global nutrition targets 2025: breastfeeding policy brief, WHO\/NMH\/NHD714, 2014. Available: http:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/149022\/WHO_NMH_NHD_14.7_eng.pdf;jsessionid=9545E906BED1ABC5A99A8558F4669F3B?sequence=1"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2018-211148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T12:53:23Z","timestamp":1759496003000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2018-211148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,13]]},"references-count":35,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2019,6,10]]},"published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1136\/jech-2018-211148"],"URL":"https:\/\/doi.org\/10.1136\/jech-2018-211148","relation":{},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,13]]}}}