Maternity Care Practices and Breastfeeding Intentions at One Month Among Low-Income Women

Abstract

BACKGROUND: Maternity care practices have been linked with higher chances of meeting breastfeeding intentions, but this relationship has not been examined using national data on US low-income women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS: Using data from the WIC Infant and Toddler Feeding Practices Study-2 on 1080 women who intended to breastfeed, we estimated risk ratios for associations between (1) each of 6 maternity care practices supportive of breastfeeding (breastfeeding within 1 hour of birth, showing mothers how to breastfeed, giving only breast milk, rooming-in, breastfeeding on demand, no pacifiers), (2) each practice adjusted for all other practices, and (3) total number of practices experienced with whether women met their intention to feed only breast milk at 1 month old. Models were adjusted for demographics. RESULTS: In adjusted models (1), breastfeeding within 1 hour of birth, giving only breast milk, and no pacifiers were associated with higher likelihood of meeting prenatal breastfeeding intentions. Adjusting for all other practices (2), initiating breastfeeding within 1 hour of birth (risk ratio: 1.3; 95% confidence interval: 1.0–1.6) and giving only breast milk (risk ratio: 4.4; 95% confidence interval: 3.4–5.7) remained associated with meeting breastfeeding intention. There was a dose-response relationship between number of steps experienced and higher likelihood of meeting prenatal breastfeeding intentions (3). CONCLUSIONS: Women who experienced maternity care practices supportive of breastfeeding were more likely to meet their prenatal breastfeeding intentions, underscoring the importance of breastfeeding support during the birth hospitalization in enabling mothers to achieve their breastfeeding goals.

Perinatal Hospital Practices Are Associated with Breastfeeding through 5 Months Postpartum among Women and Infants from Low-Income Households

“…The current study adds to a growing body of literature reporting that receiving more BF supports at the hospital is associated with increased likelihood and duration of BF. Previous research has established a dose-response relationship between BF-friendly hospital practices and BF initiation [ 17 ], EBF at the hospital [ 21 ] and 1 wk postpartum [ 16 ], and meeting intentions to fully BF at 1 mo [ 23 ]. However, studies examining the association between the number of hospital supports and later BF have yielded somewhat mixed results [ 20 , 21 , 41 ], which may be related to methodological differences and/or regional differences in BF culture.…”

“…The WIC Infant and Toddler Feeding Practices Study II (ITFPS-2), which aimed to update and expand data on feeding practices and behaviors among infants and toddlers being served by WIC, provides a nationally representative sample of English- or Spanish-speaking WIC participants. Data from ITFPS-2 have previously demonstrated that initiating BF within 1 h of birth, providing no foods or drinks other than breastmilk, not providing pacifiers, and experiencing more BFHI steps overall increased the likelihood of meeting BF intentions at 1 mo of age [ 23 ]. However, in that study, neither the influence of receiving a pro-formula gift pack nor BF outcomes beyond 1 mo were assessed.…”

Breastfeeding Support

“…Breastfeeding counseling during pregnancy has been linked to an increase in the likelihood of meeting breastfeeding intentions and practices during the postnatal period. Women who experienced supportive antenatal care practices were more likely to fulfill their prenatal breastfeeding intentions mainly initiation of breastfeeding within one hour and giving only breast milk in the first six months [19].…”

“…The place of delivery was the integral component for the promotion and actual implementation of optimal breastfeeding practices. Effective breastfeeding support during labor and delivery hospitalization is crucial for mothers to be able to achieve their breastfeeding goals [19].…”

Association between place of birth and timely breastfeeding initiation among Cambodian women: a population-based study

“…Timely breastfeeding initiation in Cambodia remains low. While breastmilk substitute promotion persists [ 17 ] and BFHI compliance assessment is lacking [ 28 , 29 ], health professionals and facilities can protect breastfeeding by promoting SSC, rooming-in, recruiting government support, and offering lactation counseling [ 30 , 31 ]. With two-thirds of public health professionals working privately in Cambodia [ 26 ], crossover training has greater potential across sectors for breastfeeding advocacy.…”