• antenatal education;
  • breastfeeding;
  • breastfeeding duration;
  • childbirth education;
  • prenatal care;
  • primary care midwives



To assess the association between attendance at antenatal education sessions and breastfeeding during the first year of life.


Although there is evidence that antenatal education encourages breastfeeding, the size and duration of its effect remain unclear.


A prospective cohort study.


The study was conducted in Bizkaia (North of Spain) between May 2005–June 2007 with a consecutive sample of 614 primiparas. Women were classified into three groups according to whether they had received antenatal education and, if so, how many classes (0, 1–4, or 5 or more). Telephone interviews at 1·5, 3, 6 and 12 months were used to estimate the risk of cessation of any breastfeeding and to compare the groups with Cox proportional hazards regression models adjusted for potential confounders.


Initially, 90% of women breastfed their infants, with no differences between the groups. During the first month, the risk of cessation of any breastfeeding was three times as high among non-attendees and twice as high among women who attended 1–4 classes compared with those who attended 5 or more classes. The risk was, however, similar in the three groups from the end of first month onwards.


The results suggest that though antenatal education may be associated with higher rates of breastfeeding in our setting this is only the case for the first month after the birth. Further research is necessary to optimize this beneficial effect to achieve long-term continuation of breastfeeding.