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

Journal article

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

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Authors	Michelle O'Connor, Jyai Allen, Jennifer Kelly, Yu Gao and Sue Kildea
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; infant formula; opioid analgesics; epidural analgesia; midwifery; postnatal care
Year	2018
Journal	Australian Midwifery
Journal citation	31 (4), pp. 319-324
Publisher	Elsevier BV
ISSN	1871-5192
Digital Object Identifier (DOI)	https://doi.org/10.1016/j.wombi.2017.10.013
Scopus EID	2-s2.0-85034971429
Publisher's version	File Access Level Controlled
Deposited	12 May 2021

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