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Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed.

Declercq E, Labbok MH, Sakala C, O'Hara M

Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany St, Talbot W540, Boston, MA 02118, USA. declercq@bu.edu

OBJECTIVES: We sought to assess whether breastfeeding-related hospital practices reported by mothers were associated with achievement of their intentions to exclusively breastfeed. METHODS: We used data from Listening to Mothers II, a nationally representative survey of 1573 mothers who had given birth in a hospital to a singleton in 2005. Mothers were asked retrospectively about their breastfeeding intention, infant feeding at 1 week, and 7 hospital practices. RESULTS: Primiparas reported a substantial difference between their intention to exclusively breastfeed (70%) and this practice at 1 week (50%). They also reported hospital practices that conflicted with the Baby-Friendly Ten Steps, including supplementation (49%) and pacifier use (45%). Primiparas who delivered in hospitals that practiced 6 or 7 of the steps were 6 times more likely to achieve their intention to exclusively breastfeed than were those in hospitals that practiced none or 1 of the steps. Mothers who reported supplemental feedings to their infant were less likely to achieve their intention to exclusively breastfeed: primiparas (adjusted odds ratio [AOR] = 4.4; 95% confidence interval [CI] = 2.1, 9.3); multiparas (AOR = 8.8; 95% CI = 4.4, 17.6). CONCLUSIONS: Hospitals should implement policies that support breastfeeding with particular attention to eliminating supplementation of healthy newborns.

Published 13 April 2009 in Am J Public Health, 99(5): 929-35.
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Breastfeeding Books

Breastfeeding the Newborn: Clinical Strategies for Nurses

Breastfeeding the Newborn: Clinical Strategies for Nurses