A Comparison of Breastfeeding Experiences between Mothers Spending the Traditional Chinese Confinement Period in a Confinement Centre or at Home

Abstract

BackgroundEthnic Chinese mothers in Malaysia adhere to 30 days of traditional post-partum practices (the “confinement period”) aimed at recuperation after delivery. Recently there has been an emergence of confinement centres (CCs), where mothers stay and receive traditional confinement care. Ethnic Chinese mothers have low breastfeeding rates. There are concerns that practices in CCs could contribute to this but no data exists. We describe mother’s breastfeeding experience at CCs and identify areas for potential improvement in breastfeeding support.MethodsEthnic Chinese mothers intending to breastfeed their healthy infants were recruited post-delivery, then telephone interviewed about their experience 1 and 6 months later. For every participant going to CCs, another mother going home was recruited. Chi-square test was used to compare groups and multiple logistic regression was used to assess the effect of confinement place on exclusive breastfeeding. Results Of 187 mothers, 88(47%) went to CCs. Significantly more were primigravida and fewer had previous breastfeeding experience. Response rates for one- and 6- month interviews were 87.5% (CC) vs 97% (home); and 77.3% (CC) versus 86.7% (home).Exclusive breastfeeding rates at 1 and 6 months were similar between the groups. Multiple logistic regressiondid not show that CCs were a factor affecting exclusive breastfeeding rates at 1 month (adjusted odds ratio (aOR) 1.66, 95% confidence interval(CI) 0.85 to 3.28) or 6 months (aOR 0.86, 95% CI 0.44 to 1.70). However, significantly more CC participants only fed expressed breastmilk. Despite 66% of CC participants reporting that their centre supported breastfeeding, only 6(8%) CC participants compared to 66(69%) of home participants slept with their baby. The proportion encountering breastfeeding difficulties were similar between groups. CC participants sought help for breastfeeding problems mainly from CC staff and support groups while home participants obtained help from friends and healthcare professionals. ConclusionsContrary to current perceptions, breastfeeding experience and breastfeeding rates were similar at CCs and home but there were gaps in how CCs supported breastfeeding. Targeted training to CC staff to support breastfeeding may result in better outcomes for mothers staying in CCs. Trial registrationNational Medical Research Register NMRR-17-1174-36384S1