title: Impact of baby-friendly hospital practices on breastfeeding in Hong Kong.
abstract: BACKGROUND
  The World Health Organization (WHO) developed the Baby-Friendly Hospital Initiative to improve hospital maternity care practices that support breastfeeding. In Hong Kong, although no hospitals have yet received the Baby-Friendly status, efforts have been made to improve breastfeeding support. The aim of this study was to examine the impact of Baby-Friendly hospital practices on breastfeeding duration.
  
  
  METHODS
  A sample of 1,242 breastfeeding mother-infant pairs was recruited from four public hospitals in Hong Kong and followed up prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for 8 weeks or less. Predictor variables included six Baby-Friendly practices: breastfeeding initiation within 1 hour of birth, exclusive breastfeeding while in hospital, rooming-in, breastfeeding on demand, no pacifiers or artificial nipples, and information on breastfeeding support groups provided on discharge.
  
  
  RESULTS
  Only 46.6 percent of women breastfed for more than 8 weeks, and only 4.8 percent of mothers experienced all six Baby-Friendly practices. After controlling for all other Baby-Friendly practices and possible confounding variables, exclusive breastfeeding while in hospital was protective against early breastfeeding cessation (OR: 0.61; 95% CI: 0.42-0.88). Compared with mothers who experienced all six Baby-Friendly practices, those who experienced one or fewer Baby-Friendly practices were almost three times more likely to discontinue breastfeeding (OR: 3.13; 95% CI: 1.41-6.95).
  
  
  CONCLUSIONS
  Greater exposure to Baby-Friendly practices would substantially increase new mothers' chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines.
authors: School of Nursing, University of Hong Kong.
authors: Marie
authors: M
authors: Tarrant
authors: Kendra M
authors: KM
authors: Wu
authors: Daniel Y T
authors: DY
authors: Fong
authors: Irene L Y
authors: IL
authors: Lee
authors: Emmy M Y
authors: EM
authors: Wong
authors: Alice
authors: A
authors: Sham
authors: Christine
authors: C
authors: Lam
authors: Joan E
authors: JE
authors: Dodgson
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006293:Health Promotion; D006723:Hong Kong; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000592:standards*; D016134:Organizational Policy; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011446:Prospective Studies; D014944:World Health Organization; D055815:Young Adult