Impact of accreditation of baby friendly hospital in Hong Kong on the duration and exclusivity of breastfeeding

Abstract

Baby-friendly Hospital Initiative (BFHI) was first launched in 1991 by World Health Organization to promote breastfeeding through hospital practices. This is the first study to compare any and exclusive breastfeeding rates of mothers delivering from a Baby-friendly Hospital against non-accredited hospitals in a Hong Kong setting. The aim is to examine the impact of Baby-Friendly Hospital after achieving accreditation on any and exclusive breastfeeding rates at 1, 3 and 6-month in Hong Kong by comparing it to a previous cohort when they were non-accredited. This study used a repeated prospective cohort study design. Two cohorts of mother-infant pairs (n = 2077) were recruited immediate postpartum from four public hospitals in Hong Kong and followed up prospectively for up to six months. Any and exclusive breastfeeding duration were compared between the two cohorts and adjusted for sociodemographic. Significant greater number of mothers were breastfeeding at 1-, 3-, and 6-month that delivered in accredited Baby-friendly Hospitals compared to the non-accredited hospitals. By the 6thmonth, 65.7% of mothers were still breastfeeding in the 2019, whereas only 38.9% were breastfeeding in the 2013 cohort. After adjusting for possible confounders, mothers of the accredited BFHI hospitals were 2.93, 3.39 and 3.02 more likely to be breastfeeding than mothers of the non-accredited BFHI hospitals at 1-, 3-, and 6- months, respectively. Mothers of accredited BFHI hospitals was 25% [95% CI: 1.01-1.54] more likely to be breastfeeding at 3 months and 54% [95% CI: 1.22-1.95] more likely to be breastfeeding at 6 months. Women delivered in a Baby-Friendly Hospital had higher any and exclusive breastfeeding rates and duration when compared to women who did not. Future studies should ensure strict adherence to the BFHI policies and to identify more ways to improve exclusive breastfeeding.