Baby friendly hospital and breastfeeding duration of mothers from Hong Kong

Abstract

The Baby-friendly Hospital Initiative was first launched in 1991 by World Health Organization to promote breastfeeding through hospital practices. The aim of this study was to examine the impact of a Baby-friendly Hospital on breastfeeding duration. A sample of 790 mother-infant pairs was recruited from accredited Baby-friendly Hospitals in Hong Kong and followed up prospectively for up to six months. Six baby-friendly practices were used as a predictor variables: breastfeeding within 1 hour of birth, giving only breastmilk, rooming-in 24 hours a day, breastfeeding on infants’ cues, no pacifier or feeding bottles, and coordinating discharge for mothers to have ongoing care. Over sixty percent (61.8%) of mothers breastfed for 26 weeks or more. Over a tenth of the mothers experienced all six steps (12.2%), while near half of the mothers experienced five (45.9%). In the adjusted analysis, Mothers who gave breastmilk only during their hospital stay were 2.32 times more likely [95% CI:1.36-3.93] to breastfeed for at least 26 weeks than mothers who gave supplements. Similarly, mothers who breastfed on demand were 1.61 times more likely [95% CI: 1.03-2.52] to breastfeed for at least 26 weeks than mothers who did not. A dose response was observed between number of hospital practices experienced and average breastfeeding duration. Mothers who reported experiencing four Baby-Friendly practices were 2.10 times more likely [95% CI: 1.09-4.04] to breastfeed for at least 26 weeks compared to mothers who experienced two or less. Furthermore, mothers who experienced five and six steps were 2.50 and 4.41 times (respectively) more likely to breastfeed at least 26 weeks compared to mothers who experienced two or less. Exposure to BFHI program has shown to be important in protecting mothers from early cessation of breastfeeding.