Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation

A prospective cohort study

Michelle O'Connor, Jyai Allen, Jennifer Kelly, Yu Gao, Sue Kildea

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: The aim of this study was to investigate the maternity care factors associated with exclusive breastfeeding duration at three months and six months postpartum in a setting without BFHI accrediation.

Methods: A prospective cohort design. Participants from one tertiary maternity hospital were eligible if they intended to exclusively breastfeed, had birthed a live, term baby; were breastfeeding at recruitment; were rooming-in with their baby; were healthy and well; and understood English. Participants completed an infant feeding survey using 24-h recall questions at three time-points. Data were analysed using descriptive statistics, bivariate analysis and regression modelling.

Findings: We recruited 424 participants of whom 84% (n = 355) responded to the survey at 3-months and 79% (n = 335) at 6-months. Women who avoided exposure to intrapartum opioid analgesia (e.g. intramuscular, intraveous or epidural) were more likely to be exclusively breastfeeding at 3-months postpartum (adjusted odds ratio (aOR) 2.09, 95% confidence interval (CI) 1.15–3.80, probability value (p) 0.016). The only other modifiable predictor of exclusive breastfeeding at 3-months was non-exposure to artificial formula on the postnatal ward (aOR 2.44, 95% CI 1.43–4.18, p < 0.001). At 6-months postpartum, the rate of exclusive breastfeeding had reduced to 5% (n = 16) which rendered regression modelling untenable.

Discussion: Strategies to decrease exposure to opioid analgesia in birth settings and the use of infant formula on the postnatal ward may improve exclusive breastfeeding at three months.

Conclusion: Results suggest that both intrapartum and postpartum maternity care practices can predict long-term breastfeeding success.

Original languageEnglish
Pages (from-to)319-324
Number of pages6
JournalWomen and Birth
Volume31
Issue number4
DOIs
Publication statusPublished - 1 Aug 2018
Externally publishedYes

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Accreditation
Breast Feeding
Cohort Studies
Prospective Studies
Postpartum Period
Analgesia
Opioid Analgesics
Odds Ratio
Confidence Intervals
Postnatal Care
Maternity Hospitals
Infant Formula
Tertiary Care Centers
Regression Analysis
Parturition

Cite this

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title = "Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation: A prospective cohort study",
abstract = "Aim: The aim of this study was to investigate the maternity care factors associated with exclusive breastfeeding duration at three months and six months postpartum in a setting without BFHI accrediation. Methods: A prospective cohort design. Participants from one tertiary maternity hospital were eligible if they intended to exclusively breastfeed, had birthed a live, term baby; were breastfeeding at recruitment; were rooming-in with their baby; were healthy and well; and understood English. Participants completed an infant feeding survey using 24-h recall questions at three time-points. Data were analysed using descriptive statistics, bivariate analysis and regression modelling. Findings: We recruited 424 participants of whom 84{\%} (n = 355) responded to the survey at 3-months and 79{\%} (n = 335) at 6-months. Women who avoided exposure to intrapartum opioid analgesia (e.g. intramuscular, intraveous or epidural) were more likely to be exclusively breastfeeding at 3-months postpartum (adjusted odds ratio (aOR) 2.09, 95{\%} confidence interval (CI) 1.15–3.80, probability value (p) 0.016). The only other modifiable predictor of exclusive breastfeeding at 3-months was non-exposure to artificial formula on the postnatal ward (aOR 2.44, 95{\%} CI 1.43–4.18, p < 0.001). At 6-months postpartum, the rate of exclusive breastfeeding had reduced to 5{\%} (n = 16) which rendered regression modelling untenable. Discussion: Strategies to decrease exposure to opioid analgesia in birth settings and the use of infant formula on the postnatal ward may improve exclusive breastfeeding at three months. Conclusion: Results suggest that both intrapartum and postpartum maternity care practices can predict long-term breastfeeding success.",
keywords = "Breastfeeding, Epidural analgesia, Infant formula, Midwifery, Opioid analgesics, Postnatal care",
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Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation : A prospective cohort study. / O'Connor, Michelle; Allen, Jyai; Kelly, Jennifer; Gao, Yu; Kildea, Sue.

In: Women and Birth, Vol. 31, No. 4, 01.08.2018, p. 319-324.

Research output: Contribution to journalArticleResearchpeer-review

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