Predictors of breastfeeding exclusivity among Hong Kong women intending to exclusively breastfeed: Results from a multi-center study

Abstract

Although the World Health Organization (WHO) recommends six-months of exclusive breastfeeding to ensure optimal infant growth and development, many women in industrialized countries fall short of this goal. The objective of this study was to assess the predictors of two and six months exclusive breastfeeding in a cohort of Hong Kong women who planned to exclusively breastfeed. A total of 960 participants were recruited from four public hospitals in Hong Kong. We used logistic regression to assess the association between sociodemographic characteristics, breastfeeding support variables, hospital practices, and exclusive breastfeeding. Only 59.8% (n=574) of participants exclusively breastfed for any duration. At two months postpartum, previous breastfeeding experience (OR=3.14; 95% CI 1.47-6.71), exclusive breastfeeding during the postpartum hospitalization (OR=1.88; 95% CI 1.40-2.51), and recent migration to Hong Kong (OR=2.15; 95% CI 1.20-3.85) were positively associated with exclusive breastfeeding while returning to work (OR=0.52; 95% CI 0.37-0.74) and the partner's preference for infant formula (OR=0.28; 95% CI 0.08-0.997) were negatively associated with exclusive breastfeeding. Only previous breastfeeding experience (OR=2.55; 95% CI 1.08-6.01) and in-hospital exclusive breastfeeding (OR=1.80; 95% CI 1.30-2.49) were positively associated with six-months of exclusive breastfeeding while participants returning to work (OR=0.42; 95% CI 0.28-0.61) were 60% less likely to meet this goal. In-hospital exclusive breastfeeding nearly doubled the odds of meeting the WHO recommended six-months of exclusive breastfeeding. Therefore, unnecessary in-hospital formula supplementation should be avoided where possible. Longer maternity leave and greater breastfeeding support when returning to paid employment may help more new mothers achieve their breastfeeding goals.