title: Feeding infants directly at the breast during the postpartum hospital stay is associated with increased breastfeeding at 6 months postpartum: a prospective cohort study.
abstract: OBJECTIVE
  To explore whether feeding only directly from the breast in the first 24-48 h of life increases the proportion of infants receiving any breast milk at 6 months.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Three maternity hospitals in Melbourne, Australia.
  
  
  METHODS
  1003 postpartum English-speaking women with a healthy singleton term infant, who intended to breast feed, were recruited between 2009 and 2011. Women were excluded if they or their infant were seriously ill. 92% (n=924) were followed up at 6 months postpartum.
  
  
  METHODS
  Main exposure variable - type of infant feeding in hospital up to time of study recruitment (24-48 h postpartum), categorised as 'fed directly at the breast only' or 'received at least some expressed breast milk (EBM) or infant formula'. Primary outcome - proportion of infants receiving any breast milk feeding at 6 months postpartum. Secondary outcomes - proportion of infants receiving only breast milk feeding at 6 months; breast milk feeding duration; and maternal characteristics associated with giving any breast milk at 6 months.
  
  
  RESULTS
  Infants who had fed only at the breast prior to recruitment were more likely to be continuing to have any breast milk at 6 months than those who had received any EBM and/or infant formula (76% vs 59%; adjusted OR 1.76, 95% CI 1.24 to 2.48 (adjusted for parity, type of birth, breastfeeding intention, breastfeeding problems at recruitment, public/private status, epidural for labour or birth, maternal body mass index and education)).
  
  
  CONCLUSIONS
  Healthy term infants that fed only directly at the breast 24-48 h after birth were more likely to be continuing to breast feed at 6 months than those who received any EBM and/or formula in the early postpartum period. Support and encouragement to initiate breastfeeding directly at the breast is important.
authors.affiliation: Judith Lumley Centre (formerly Mother and Child Health Research), La Trobe University, Melbourne, Victoria, Australia Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Della A
authors.initials: DA
authors.lastname: Forster
authors.affiliation: Judith Lumley Centre (formerly Mother and Child Health Research), La Trobe University, Melbourne, Victoria, Australia Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Helene M
authors.initials: HM
authors.lastname: Johns
authors.affiliation: Judith Lumley Centre (formerly Mother and Child Health Research), La Trobe University, Melbourne, Victoria, Australia School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria, Australia.
authors.forename: Helen L
authors.initials: HL
authors.lastname: McLachlan
authors.affiliation: Judith Lumley Centre (formerly Mother and Child Health Research), La Trobe University, Melbourne, Victoria, Australia Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Anita M
authors.initials: AM
authors.lastname: Moorhead
authors.affiliation: Mercy Hospital for Women, Heidelberg, Victoria, Australia.
authors.forename: Kerri M
authors.initials: KM
authors.lastname: McEgan
authors.affiliation: Judith Lumley Centre (formerly Mother and Child Health Research), La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Amir
mesh_terms: D000328:Adult; D001315:Australia; D001942:Breast Feeding; D004032:Diet; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008875:Middle Aged; D008895:Milk, Human; D010298:Parity; D049590:Postpartum Period; D011446:Prospective Studies; D055815:Young Adult
keywords: NUTRITION & DIETETICS; PERINATOLOGY; PUBLIC HEALTH