A Validation Study of Maternal Recall on Breastfeeding Duration Six Years after Childbirth. Pubblico

Abstract

Background: Previous research studies have often depended on a mother's ability to recall her breastfeeding duration several years after delivery. Mothers have been reported to accurately recall their breastfeeding initiation and duration when the recall period is (less than 3 years); however, very few studies have assessed the validity of long-term maternal recall. The objective of this study is to assess the validity of maternal recall of breastfeeding 6 years after childbirth, and the association between accurate maternal recall of breastfeeding and socio-demographic factors.

Methods: The two data sets used i.e. Infant Feeding Practices Study 2 (IFPS2) and Year 6 Follow-up (Y6FU) were obtained from the Center for Disease Control (CDC). Data on breastfeeding duration collected from 2005 to 2007 (baseline) was compared to breastfeeding recall data obtained six years later among 856 study participants. The Intra-Class correlation coefficient (ICC) and Bland-Altman plots were examined as a measure of agreement between the two data sets. Sensitivity and specificity estimates were calculated to assess validity of recall. Socio-demographic determinants associated with accurate recall to within one month was examined using multiple logistic regression analysis.

Results: Maternal recall of breastfeeding duration was found to be fairly valid after 6 years of childbirth with a small median overall bias (0.2weeks) toward overestimation. The overall concordance was high (ICC=0.84) and observed to be consistently high among the different socio-demographic groups except among mothers between the ages of 23 to 30 years and smokers. Parity was the only significant predictor of accurate recall to within one month of the baseline study (adjusted OR 0.69; 95% CI 0.5, 1.0, p-value 0.023).

Conclusion: Our study found that maternal recall of breastfeeding duration was fairly accurate even after 6 years of childbirth. Further research studies are required to identify the different socio-demographic groups less likely to give accurate recall of breastfeeding duration, and the magnitude and direction of the bias, so researchers relying on their recall can handle the data with care.

Table of Contents

Introduction.....................................................................................1

Methods...........................................................................................4

Results.............................................................................................9

Discussion.......................................................................................13

References.......................................................................................19

List of figures

Figure 1: Cohort Profile.....................................................................23

Figure 2: Distribution of IFPS2 breastfeeding duration........................27

Figure3: Distribution of Y6FU breastfeeding duration..........................28

Figure4: Bland-Altman Plot...............................................................29

Figure 1B: Cohort Profile for median imputation.................................34

Figure 2B: Distribution of IFPS2 breastfeeding duration for median imputation........38

Figure 3B: Distribution of IFPS2 breastfeeding duration for median imputation........39

Figure 4: Bland-Altman plot for median imputation............................40

List of Tables

Table1.............................................................................................25

Table2.............................................................................................30

Table3.............................................................................................31

Table1B...........................................................................................36

Table2B...........................................................................................41

Table3B...........................................................................................43

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Executive Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Parola chiave	any breastfeeding duration maternal recall validation
Committee Chair / Thesis Advisor	Kancherla, Vijaya, Emory University
Committee Members	Li, Ruowei, CDC Ko, Yi-An , Emory University

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