Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity

Vehling, Lorena; Chan, Deborah; McGavock, Jon; Becker, Allan B.; Subbarao, Padmaja; Moraes, Theo J.; Mandhane, Piushkumar J.; Turvey, Stuart E.; Lefebvre, Diana L.; Sears, Malcolm R.; Azad, Meghan B.

doi:10.1111/birt.12345

Cited by 47 publications

(60 citation statements)

References 30 publications

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“…According to previous studies that evaluated some of the practices examined here, breastfeeding in the first hour of life, no supplementation with infant formula, and no pacifier use were the practices most strongly associated with longer breastfeeding duration (DiGirolamo, Grummer‐Strawn, & Fein, ). A recent study conducted in Canada also showed that babies who were breastfed exclusively during their stay in the maternity ward were breastfed for longer when compared with those who received formula (median: 11 vs. 7 months; Vehling et al, ), corroborating the findings of the present study.…”

Section: Discussionsupporting

confidence: 91%

Combined pro‐breastfeeding practices are advantageous in facilities providing maternity and newborn services

Bizon

Giugliani

Lago

et al. 2019

Maternal & Child Nutrition

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This study aimed to evaluate the association between a set of pro‐breastfeeding practices in facilities providing maternity and newborn services and the prevalence of exclusive breastfeeding at 30 days postpartum, considering the contribution of each practice. A cross‐sectional study nested within a cohort study was conducted with 287 women who delivered healthy term infants in two hospitals in southern Brazil. They were interviewed at home at 30 days postpartum. The following practices were evaluated: skin‐to‐skin contact soon after birth, breastfeeding in the first hour, uninterrupted rooming‐in, professional support with breastfeeding, breastfeeding guidance, encouragement to breastfeed on demand, no supplementation with infant formula, and no pacifier use. A score of pro‐breastfeeding practices was calculated using a logistic model, which allowed each practice to have its discriminatory capacity and difficulty estimated individually. Poisson regression was used to estimate the association between exclusive breastfeeding at 30 days and the pro‐breastfeeding practice score. The prevalence of exclusive breastfeeding at 30 days was 61.7%. The practices with greatest discriminatory capacity, that is, those that contributed most to the score estimates, were professional support with breastfeeding, breastfeeding guidance, and encouragement to breastfeed on demand. The most difficult ones were breastfeeding in the first hour, encouragement to breastfeed on demand, and non‐utilization of infant formula. For each unit (standard deviation) of increase in the score, there was an increase of 20% in the prevalence of exclusive breastfeeding at 30 days. We conclude that the set of pro‐breastfeeding practices assessed here increased the effect of these practices on exclusive breastfeeding rates at 30 days.

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Section: Discussionsupporting

confidence: 91%

Combined pro‐breastfeeding practices are advantageous in facilities providing maternity and newborn services

Bizon

Giugliani

Lago

et al. 2019

Maternal & Child Nutrition

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“…Providing an infant with anything other than breast milk in the first few days after birth (prelacteal feeding) is associated with delayed initiation of breastfeeding (Grassley, Schleis, Bennett, Chapman, & Lind, ; Sharma & Byrne, ) and increases risk of pathogenic infection and diarrheal disease (Debes et al, ; Ogbo, Page, Idoko, Claudio, & Agho, ). In‐hospital breast milk substitute (BMS) supplementation during this period has a negative impact on later exclusive and continued breastfeeding (Chantry, Dewey, Peerson, Wagner, & Nommsen‐Rivers, ; T. T. Nguyen, Withers, Hajeebhoy, & Frongillo, ; Vehling et al, ).…”

Section: Introductionmentioning

confidence: 99%

“…In-hospital breast milk substitute (BMS) supplementation during this period has a negative impact on later exclusive and continued breastfeeding (Chantry, Dewey, Peerson, Wagner, & Nommsen-Rivers, 2014;T. T. Nguyen, Withers, Hajeebhoy, & Frongillo, 2016;Vehling et al, 2018).…”

mentioning

confidence: 99%

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Champeny

Pries

Kroeun

et al. 2019

Maternal & Child Nutrition

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Introducing breast milk substitutes (BMS) in the first days after birth can increase infant morbidity and reduce duration and exclusivity of breastfeeding. This study assessed determinants of BMS feeding among newborns in delivery facilities in Phnom Penh, Cambodia, and Kathmandu Valley, Nepal. Cross‐sectional surveys were conducted among mothers upon discharge from health facilities after delivery: 304 mothers in Kathmandu Valley and 306 mothers in Phnom Penh participated. On the basis of a conceptual framework for prelacteal feeding, multivariable logistic regression was used to identify factors associated with BMS feeding prior to facility discharge. In both Phnom Penh and Kathmandu Valley, feeds of BMS were reported by over half of mothers (56.9% and 55.9%, respectively). Receiving a health professional's recommendation to use BMS increased the odds of BMS feeding in both Kathmandu Valley and Phnom Penh (odds ratio: 24.87; confidence interval [6.05, 102.29]; odds ratio: 2.42; CI [1.20, 4.91], respectively). In Kathmandu Valley, recommendations from friends/family and caesarean delivery were also associated with BMS use among mothers. Early initiation of breastfeeding and higher parity were protective against the use of BMS in Kathmandu Valley. Breastfeeding support from a health professional lowered the odds of BMS feeding among newborns. Exposure to BMS promotions outside the health system was prevalent in Phnom Penh (84.6%) and Kathmandu Valley (27.0%) but was not associated with BMS feeds among newborns. Establishment of successful breastfeeding should be prioritized before discharging mothers from delivery facilities, and health professionals should be equipped to support and encourage breastfeeding among all new mothers.

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“…Avoiding exposure to pacifiers or artificial nipples while inpatient (Step 9) increased the likelihood of any breastfeeding by a factor of 5.7, while avoiding inpatient formula supplementation (Step 6) increased the likelihood of exclusive breastfeeding by 4.4 times in the early postpartum period. Avoiding inpatient formula supplementation for nonmedical reasons has been associated with longer exclusive and partial breastfeeding duration in the literature . However, others found no effect of formula supplementation on breastfeeding outcomes .…”

Section: Discussionmentioning

confidence: 99%

“…Avoiding inpatient formula supplementation for nonmedical reasons has been associated with longer exclusive and partial breastfeeding duration in the literature. [11][12][13][14][25][26][27] However, others found no effect of formula supplementation on breastfeeding outcomes. [28][29][30] It is hypothesized that formula supplementation may interfere with the physiology of milk production because of an interruption of the natural balance between supply and demand.…”

Section: Discussionmentioning

confidence: 99%

Improved breastfeeding duration with Baby Friendly Hospital Initiative implementation in a diverse and underserved population

Kivlighan

Murray‐Krezan

Schwartz

et al. 2019

Birth

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Background Few studies have evaluated the impact of Baby Friendly Hospital Initiative (BFHI) implementation on underserved populations in the United States. We undertook this study in New Mexico, a large southwestern state with a diverse population and limited health care access. Methods A quasi‐experimental, retrospective cohort design was used to compare short‐term breastfeeding duration between a pre‐BFHI and a post‐BFHI cohort. Among the post‐BFHI cohort, logistic regression models were fitted to predict short‐term breastfeeding duration from both individual and cumulative exposure to inpatient maternity care practices (Steps 4 to 9). Results Implementation of the BFHI and cumulative exposure to the Ten Steps increased short‐term duration of any breastfeeding and exclusive breastfeeding at 2‐6 weeks postpartum. Exposure to all six of the inpatient Ten Steps increased the odds of any breastfeeding by 34 times and exclusive breastfeeding by 24 times. Exposure to Step 9 (“Give no pacifiers or artificial nipples”) uniquely increased the likelihood of any breastfeeding at 2‐6 weeks postpartum by 5.7 times, whereas Step 6 (“Give infants no food or drink other than breastmilk”) increased the rate of exclusive breastfeeding by 4.4 times at 2‐6 weeks postpartum. Conclusion These findings demonstrate that the Baby Friendly Hospital Initiative can have a positive impact on breastfeeding among underserved populations.

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Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity

Cited by 47 publications

References 30 publications

Combined pro‐breastfeeding practices are advantageous in facilities providing maternity and newborn services

Combined pro‐breastfeeding practices are advantageous in facilities providing maternity and newborn services

Predictors of breast milk substitute feeding among newborns in delivery facilities in urban Cambodia and Nepal

Improved breastfeeding duration with Baby Friendly Hospital Initiative implementation in a diverse and underserved population

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