Association Of Hospital Practices, Breastfeeding Outcomes And Gestational Age In Hong Kong

Abstract

Studies show that early term birth is associated with poorer neonatal outcomes when compared with term birth. Elective cesarean section is not recommended during the early term period as the fetus is continuing to develop. Although some study findings show that compared with full term infants, early term babies have lower rates of breastfeeding initiation and an increased likelihood of early breastfeeding cessation, research is limited. The objectives of the study were to examine the association between exposure to Baby Friendly Hospital Steps and breastfeeding duration among early term and term infants. We recruited 2560 mother-infant dyads in Hong Kong in 2006-2007 and 2011-2012 and followed them for 12 months or until breastfeeding stopped. Infants were classified as early term (37-<39 weeks), full term (39-<41 weeks) and post term (>41 weeks). Approximately one-third (32.6%) of the infants were classified as early term. There were no significant differences in the breastfeeding duration among the three groups. Among the Baby Friendly Hospital steps, breastfeeding initiation within the first hour was significantly associated with a lower risk of breastfeeding cessation in full term infants (aHR=0.85, 95% CI 0.75-0.97) but not early term (aHR=0.93, 95% CI 0.76-1.13) or late term (aHR=0.89, 95% CI 0.59-1.35) infants. Exclusive breastfeeding during the hospital stay was also associated with a decreased risk of breastfeeding cessation in the three groups. This study suggests that early term infants breastfeed for the same duration as term infants and reinforce the importance of exclusive breastfeeding during hospital stay.