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

O'Connor, Michelle and Allen, Jyai and Kelly, Jennifer and 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. ISSN 1871-5192


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.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Accepted version embargoed until 1 Sept 2019 (12 months), in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing
Date Deposited: 31 Jan 2018 05:28
Last Modified: 13 Jun 2019 06:00
Uncontrolled Keywords: breastfeeding; infant formula; opioid analgesics; epidural analgesia; midwifery; postnatal care
Fields of Research : 11 Medical and Health Sciences > 1110 Nursing > 111006 Midwifery
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified
Identification Number or DOI: 10.1016/j.wombi.2017.10.013

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