title: [Hospital practices and breastfeeding cessation risk within 6 months of delivery].
abstract: BACKGROUND
  The impact of maternity ward practices on breastfeeding duration remains uncertain in France.
  
  
  OBJECTIVE
  This study aimed to determine whether compliance with an increasing number of Baby-Friendly Hospital Initiative recommended practices was associated with a decreasing risk for breastfeeding cessation within 6 months of delivery.
  
  
  METHODS
  We analyzed the original data from a prospective cohort study carried out in eight maternity centers in France in 2005-2006. A pediatrician or a midwife prospectively collected data on breastfeeding initiation within 1h of birth, rooming-in 24h a day, pacifier non-use, and giving breast milk only for 908 mothers who were breastfeeding at discharge.
  
  
  RESULTS
  Overall, 315 (34.7%), 309 (34.0%), 186 (20.5%), and 98 (10.8%) mothers experienced 4, 3, 2, or 0-1 maternity ward practices. The median breastfeeding duration was 18 weeks (25th-75th percentiles, 9 to >26), with 87.6% and 31.5% of mothers who were still breastfeeding by 4 and 26 weeks after delivery, respectively. After adjusting for study center and baseline characteristics, the hazard ratios of breastfeeding cessation associated with 3, 2, and 0-1 practices were 1.32 (95% confidence interval [CI], 1.06-1.64), 1.54 (95% CI, 1.20-1.98), and 1.59 (95% CI, 1.13-2.25) as compared with compliance with four practices (p for trend <0.001).
  
  
  CONCLUSIONS
  Although the causal interpretation for this relationship remains speculative, these findings support interventions aimed to implement or reinforce Baby-Friendly Hospital Initiative recommended practices in order to establish prolonged breastfeeding and decrease the risk for early cessation after discharge to home.
authors.affiliation: Unité d'évaluation médicale, centre hospitalier universitaire CS 10217, pavillon Taillefer, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Callendret
authors.affiliation: Association française de pédiatrie ambulatoire, Le Polygone Alpha, 30, allée Albert-Sylvestre, 73000 Chambéry, France.
authors.forename: N
authors.initials: N
authors.lastname: Gelbert-Baudino
authors.affiliation: Pôle de biologie médicale et d'anatomie pathologique, centre hospitalier universitaire Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: T
authors.initials: T
authors.lastname: Raskovalova
authors.affiliation: Université médicale d'État, 1 ulitsa Krasnogo Vosstania, 664003 Irkoutsk, Fédération de Russie.
authors.forename: D
authors.initials: D
authors.lastname: Piskunov
authors.affiliation: 285, rue Nicolas-Parent, 73000 Chambéry, France.
authors.forename: C
authors.initials: C
authors.lastname: Schelstraëte
authors.affiliation: Département d'anesthésie réanimation, hôpital Edouard-Herriot, hospices civils de Lyon, place d'Arsonval, 69008 Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Durand
authors.affiliation: Unité d'évaluation médicale, centre hospitalier universitaire CS 10217, pavillon Taillefer, 38043 Grenoble cedex 9, France.
authors.forename: F
authors.initials: F
authors.lastname: Baudino
authors.affiliation: Unité d'évaluation médicale, centre hospitalier universitaire CS 10217, pavillon Taillefer, 38043 Grenoble cedex 9, France; TIMC, UMR 5525, CNRS université Joseph-Fourier, Grenoble 1, Domaine de la Merci, 38706 La Tronche cedex, France.
authors.forename: P
authors.initials: P
authors.lastname: François
authors.affiliation: Pôle couple enfant, centre hospitalier universitaire CS 10217, 38043 Grenoble cedex 9, France.
authors.forename: V
authors.initials: V
authors.lastname: Equy
authors.affiliation: Unité d'évaluation médicale, centre hospitalier universitaire CS 10217, pavillon Taillefer, 38043 Grenoble cedex 9, France; TIMC, UMR 5525, CNRS université Joseph-Fourier, Grenoble 1, Domaine de la Merci, 38706 La Tronche cedex, France. Electronic address: jlabarere@chu-grenoble.fr.
authors.forename: J
authors.initials: J
authors.lastname: Labarere
mesh_terms: D000328:Adult; D001942:Breast Feeding; D036861:Delivery, Obstetric; D005260:Female; D005602:France; D019983:Guideline Adherence; D006293:Health Promotion / Q000379:methods; D006771:Hospitals, Maternity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009034:Mother-Child Relations; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011181:Postnatal Care / Q000379:methods; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors