Hospital practices and women's likelihood of fulfilling their intention to exclusively breastfeed.
OBJECTIVE
We sought to assess whether breastfeeding-related hospital practices reported by mothers were associated with achievement of their intentions to exclusively breastfeed.


METHODS
We used data from Listening to Mothers II, a nationally representative survey of 1573 mothers who had given birth in a hospital to a singleton in 2005. Mothers were asked retrospectively about their breastfeeding intention, infant feeding at 1 week, and 7 hospital practices.


RESULTS
Primiparas reported a substantial difference between their intention to exclusively breastfeed (70%) and this practice at 1 week (50%). They also reported hospital practices that conflicted with the Baby-Friendly Ten Steps, including supplementation (49%) and pacifier use (45%). Primiparas who delivered in hospitals that practiced 6 or 7 of the steps were 6 times more likely to achieve their intention to exclusively breastfeed than were those in hospitals that practiced none or 1 of the steps. Mothers who reported supplemental feedings to their infant were less likely to achieve their intention to exclusively breastfeed: primiparas (adjusted odds ratio [AOR] = 4.4; 95% confidence interval [CI] = 2.1, 9.3); multiparas (AOR = 8.8; 95% CI = 4.4, 17.6).


CONCLUSIONS
Hospitals should implement policies that support breastfeeding with particular attention to eliminating supplementation of healthy newborns.
Declercq
Eugene
E
Department of Maternal and Child Health, Boston University School of Public Health, 715 Albany St, Talbot W540, Boston, MA 02118, USA. declercq@bu.edu
Labbok
Miriam H
MH
Sakala
Carol
C
O'Hara
MaryAnn
M
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D016015:Logistic Models; D009035:Mothers / Q000523:psychology / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D016017:Odds Ratio; D016134:Organizational Policy; D011247:Pregnancy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult