title: Prevalence and predictors of exclusive breastfeeding at hospital discharge.
abstract: OBJECTIVE
  To estimate the population-based prevalence and predictors of exclusive breastfeeding at hospital discharge in singleton and twin term newborns.
  
  
  METHODS
  We studied all hospital births in the province of Ontario, Canada, between April 1, 2009, and March 31, 2010, to perform a retrospective cohort study. We included live singleton and twin births, at term (37 0/7 weeks of gestation to 41 6/7 weeks of gestation), with information about feeding at maternal-newborn discharge. Descriptive statistics were performed and logistic regression was used to identify factors related to exclusive breastfeeding.
  
  
  RESULTS
  Our study population consisted of 92,364 newborns, of whom 56,865 (61.6%) were exclusively breastfed at discharge. Older, nonsmoking, higher-income mothers with no pregnancy complications or reproductive assistance were more likely to breastfeed. Mothers of twins were less likely to exclusively breastfeed (adjusted odds ratio [OR] 0.30, 95% confidence interval [CI] 0.25-0.36) as were women who did not attend prenatal classes (adjusted OR 0.80, 95% CI 0.76-0.83). Compared with patients of obstetricians (57%), women cared for by midwives (87%, adjusted OR 4.49, 95% CI 4.16-4.85) and family physicians (67%, adjusted OR 1.54, 95% CI 1.47-1.61) were more likely to exclusively breastfeed. Breastfeeding after a planned (50%, adjusted OR 0.56, 95% CI 0.52-0.60) or unplanned (48%, adjusted OR 0.48, 95% CI 0.44-0.51) cesarean delivery was less common than after a spontaneous vaginal birth (68%). Neonates born at 39, 38, and 37 weeks of gestation (compared with 41 weeks of gestation) were increasingly less likely to breastfeed (adjusted ORs 0.93, 95% CI 0.89-0.98; 0.84, 95% CI 0.80-0.88; and 0.71, 95% CI 0.67-0.76).
  
  
  CONCLUSIONS
  This large population-based study found that fewer than two thirds of term newborns are exclusively breastfed at hospital discharge, substantially lower than previously reported.
  
  
  METHODS
  II.
authors.affiliation: Department of Obstetrics & Gynecology, McMaster University, Canada. mcdonals@mcmaster.ca
authors.forename: Sarah D
authors.initials: SD
authors.lastname: McDonald
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.forename: Barbara
authors.initials: B
authors.lastname: Chapman
authors.forename: Claudio
authors.initials: C
authors.lastname: Vera
authors.forename: Lucia
authors.initials: L
authors.lastname: Giglia
authors.forename: Christoph
authors.initials: C
authors.lastname: Fusch
authors.forename: Gary
authors.initials: G
authors.lastname: Foster
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D009864:Ontario / Q000453:epidemiology; D010351:Patient Discharge; D015995:Prevalence; D012189:Retrospective Studies; D012923:Social Class