The impact of the number of children in the family on the breastfeeding duration and vaccination coverage

Aim. To assess the impact of the number of children in the family on breastfeeding duration and vaccination coverage.

Methods. 1724 mothers of 1-year old children were randomly chosen from seven children's polyclinics in St. Petersburg for an anonymous survey that was conducted by a specially designed form “Questionnaire of a mother of 1-year old children”. The questionnaire comprised of 20 open-ended and closed-ended questions, and included questions about: (1) timing of the attachment to the breast in obstetric hospitals; (2) causes and timing of breastfeeding abandonment; (3) presence or absence of vaccinations in the first year of life according to the National preventive vaccination schedule; (4) and reasons for mothers refusing to vaccinate their children.

Results. The proportion of mothers who started artificial feeding in maternity wards immediately after the birth of the baby was the smallest among women for whom this baby was the first-born (3.4%), and the largest among fami­lies with many children (11.3%). On average, mothers with one child are breastfed until 7.36±0.11 months, with two children until 8.29±0.11 months, with three or more children until 8.78±0.10 months. By using one-way analysis of variance (ANOVA), it was shown the effect of the number of children in the family on the duration of breastfee­ding (F=3.3). Correlation analysis revealed the negative relationship of the number of children in the family with the proportion of women who continued breastfeeding until 3 and 6 months (r_xy=–0.82 and r_xy=–0.88, respectively), and positive relationship with the proportion of mothers who continued to breastfeeding the baby after reaching a year (r_xy=0.89). 12.3% of children of one-child families were not vaccinated according to the National preventive vaccination schedule, 17.7% with two-child families, 28.1% in families with three or more children. It was revealed the significant cross-group effect of the number of children in the family to vaccination coverage (F=48.7). With an increase in the number of children in the family, vaccination coverage decreases, both in general (r_xy=–0.88) and against individual infections, including hepatitis B, diphtheria, whooping cough, tetanus, polio, measles and rubella (r_xy from –0.80 to –0.90).

Conclusion. The number of children in a family impacts mothers' refusals of breastfeeding and vaccination; the more children in a family, the more prolonged breastfeeding, but less vaccination coverage due to the health status of children in the first year of life.