Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation: a prospective cohort study

Article

O'Connor, Michelle, Allen, Jyai, Kelly, Jennifer, Gao, Yu and Kildea, Sue. 2018. "Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation: a prospective cohort study." Women and Birth. 31 (4), pp. 319-324. https://doi.org/10.1016/j.wombi.2017.10.013
Article Title

Predictors of breastfeeding exclusivity and duration in a hospital without Baby Friendly Hospital Initiative accreditation: a prospective cohort study

ERA Journal ID30465
Article CategoryArticle
AuthorsO'Connor, Michelle (Author), Allen, Jyai (Author), Kelly, Jennifer (Author), Gao, Yu (Author) and Kildea, Sue (Author)
Journal TitleWomen and Birth
Journal Citation31 (4), pp. 319-324
Number of Pages6
Year2018
PublisherElsevier
Place of PublicationNetherlands
ISSN1871-5192
1878-1799
Digital Object Identifier (DOI)https://doi.org/10.1016/j.wombi.2017.10.013
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S1871519217301622?via%3Dihub
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 accreditation.

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-hour 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.

Keywordsbreastfeeding; infant formula; opioid analgesics; epidural analgesia; midwifery; postnatal care
ANZSRC Field of Research 2020420499. Midwifery not elsewhere classified
Public Notes

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Byline AffiliationsAustralian Catholic University
University of Queensland
School of Health and Wellbeing
Institution of OriginUniversity of Southern Queensland
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