title: Exclusive breastfeeding after home versus hospital birth in primary midwifery care in the Netherlands.
abstract: BACKGROUND
  Breastfeeding has short-term and long-term health benefits for mother and child. We evaluated in what way birthplace was associated with the rate of exclusive breastfeeding among low risk women who gave birth in midwife-led care and who had expressed the intention to breastfeed.
  
  
  METHODS
  We used data from the DELIVER study, which includes pregnant women from twenty midwifery practices across the Netherlands between September 2009 and April 2011. We used data from two questionnaires: one in the third trimester (after 34 weeks) and one after the birth (median 39 days postpartum). Only women who indicated an intention to breastfeed were included in the analyses. Multivariable logistic regression analysis was used to assess the association between birthplace and exclusive breastfeeding, adjusted for relevant confounders.
  
  
  RESULTS
  The exclusive breastfeeding rate was 75.0% for the 547 women who gave birth at home, and 68.5% for the 165 women who gave birth in midwife-led care in hospital. The adjusted odds ratio for exclusive breastfeeding after a hospital birth compared to a home birth was 0.79 (95% CI 0.53-1.18). The most frequently reported reason for not breastfeeding at the time of completing the postpartum questionnaire was 'my baby was not drinking enough' (47%).
  
  
  CONCLUSIONS
  In the Netherlands, among low risk women who intended to breastfeed their baby, the breastfeeding success rate did not differ significantly between home and midwife-led hospital births. As breastfeeding has short-term and long-term health benefits for mother and child, women should receive adequate lactation support by healthcare workers during the critical postpartum period, regardless of the place where they give birth.
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. pauldc@hotmail.co.uk.
authors.forename: T P
authors.initials: TP
authors.lastname: de Cock
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Judithmannien@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Manniën
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. c.geerts@vumc.nl.
authors.forename: C
authors.initials: C
authors.lastname: Geerts
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Trudy.klomp@inholland.nl.
authors.forename: T
authors.initials: T
authors.lastname: Klomp
authors.affiliation: Department of Midwifery Science, AVAG and the EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. j.dejonge1@vumc.nl.
authors.forename: A
authors.initials: A
authors.lastname: de Jonge
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006700:Home Childbirth / Q000523:psychology / Q000706:statistics & numerical data*; D006771:Hospitals, Maternity / Q000706:statistics & numerical data*; D006801:Humans; D008880:Midwifery / Q000379:methods / Q000706:statistics & numerical data*; D009035:Mothers / Q000523:psychology*; D009426:Netherlands; D016017:Odds Ratio; D049590:Postpartum Period / Q000523:psychology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third / Q000523:psychology; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D055815:Young Adult