Factors Associated With Exclusive Breastfeeding At Hospital Discharge Among Hong Kong Chinese Women

Abstract

Exclusive breastfeeding is recommended by the World Health Organization (WHO) for the first six months of life. Exclusive breastfeeding at hospital discharge has been shown to be associated with a significantly lower rate of breastfeeding cessation up to 6 months postpartum. However, rates of exclusive breastfeeding at hospital discharge in Hong Kong are low. The purpose of this study was to identify sociodemographic and perinatal factors that were associated with exclusive breastfeeding at hospital discharge. A cohort of 1265 mother-infant pairs was recruited from four public hospitals in Hong Kong. Chi-square tests were used to examine the relationship between various maternal sociodemographic characteristics and whether or not the mothers exclusively breastfeed their babies in hospital. Multivariable Logistic Regression was used to identify the adjusted associations between these factors and in-hospital exclusive breastfeeding. Of the 1265 participants, 525 (41.5%) were exclusively breastfeeding at hospital discharge. Planning to exclusively breastfeed (OR=2.13; 95% CI 1.51, 3.0), breastfeeding initiation in the delivery room (OR=3.36; 95% CI 2.56, 4.41), rooming-in (OR=2.77; 95% CI 1.64, 4.70), and on-demand breastfeeding (OR=2.14; 95% CI 1.21, 3.77) were all positively associated with in-hospital exclusive breastfeeding. A higher birth weight (≥3750 grams) deceased the likelihood of exclusive breastfeeding (OR=0.43, 95% CI 0.22, 0.84). In this cohort of healthy newborns, rates of exclusive breastfeeding at hospital discharge are suboptimal. Greater focus is needed on reducing unnecessary in-hospital formula supplementation and promoting and supporting exclusive breastfeeding.