Open Access Research

Uneven chances of breastfeeding in Spain

Isabel Río1*, Álvaro Luque2, Adela Castelló-Pastor1, María del Val Sandín-Vázquez3, Rosana Larraz3, Carmen Barona45, Mireia Jané6 and Francisco Bolúmar35

Author Affiliations

1 National Centre of Epidemiology, Institute of Health Carlos III, Madrid, Spain

2 Faculty of Sciences, University of Alicante, Alicante, Spain

3 Department of Public Health Sciences, Faculty of Medicine, University of Alcalá, Madrid, Spain

4 Department of Health, General Directorate of Public Health, Generalitat Valenciana, Valencia, Spain

5 Division of Environmental and Reproductive Epidemiology, Spanish Network for Research in Epidemiology and Public Health (CIBERESP), Valencia, Spain

6 Department of Health, Mother and Child Health Program, General Directorate of Public Health, Barcelona, Catalonia, Spain

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International Breastfeeding Journal 2012, 7:22  doi:10.1186/1746-4358-7-22

Published: 27 December 2012



No large scale studies on breastfeeding onset patterns have been carried out in Spain. This work aims to explore the prevalence and the risk factors for not initiating breastfeeding in hospitals from Catalonia (CAT) and Valencia (V), two regions accounting approximately for 30% of the annual births in Spain.


The prevalence of not initiating breastfeeding was calculated by maternal/neonatal characteristics and type of hospital, and logistic regression models were used to estimate crude and adjusted risks of not breastfeeding in each region.


Prevalence of breastfeeding initiation was 81.7% and 82.5% in Catalonia and Valencia, respectively. We identified conspicuous regional differences in the adjusted-risk of not breastfeeding, especially for multiple [CAT = 3.12 (95% CI: 2.93, 3.31), V = 2.44 (95% CI: 2.23, 2.67)] and preterm and low birth weight deliveries [very preterm and very low birth weight: CAT = 7.61 (95% CI: 6.50, 8.92), V = 4.03 (95% CI: 3.13, 5.19); moderate preterm and moderate low birth weight: CAT = 4.28 (95% CI: 4.01, 4.57), V = 2.55 (95% CI:2.34, 2.79)].


Our results suggest the existence of regional variations in breastfeeding initiation in Spain. Taking into account the known short and long-term benefits of breastfeeding it is recommended that further research should explore these differences in order to prevent potential inequities in neonatal, child and adult health.

Feeding behavior; Perinatal care; Quality of health care; Determinants of breastfeeding; Method of birth