Abstract
Objective:
The aim of this study is to examine in-hospital exclusive breastfeeding (EBF) and its association with sociodemographic factors, medical factors, breastfeeding intentions, and health care system breastfeeding support.
Materials and Methods:
We conducted a retrospective cross-sectional study using medical records from 2015 to 2019 of healthy term infants without breastfeeding contraindications at a public teaching hospital serving a racially and ethnically diverse patient population. Using multivariable regression analysis, we examined the associations between in-hospital EBF and sociodemographic factors, medical factors, breastfeeding intentions, and health care system breastfeeding support (in-hospital breastfeeding education and lactation support).
Results:
The prevalence of in-hospital EBF was 29.0%. The statistically significant findings from our fully adjusted regression analysis include that there was a higher prevalence of in-hospital EBF among adult mothers (prevalence ratio [PR]: range 1.78–1.96), married mothers (PR: 1.35, 95% confidence interval [CI]: 1.23–1.44), and mothers who were White (PR: 1.41, 95% CI: 1.20–1.66, compared with Black). Factors associated with a lower prevalence of in-hospital EBF were maternal diabetes (PR: 0.82, 95% CI: 0.70–0.95), pre-eclampsia/eclampsia (PR: 0.82, 95% CI: 0.71–0.95), cesarean delivery (PR: 0.84, 95% CI: 0.77–0.92), neonatal hypoglycemia (PR: 0.46, 95% CI: 0.36–0.59), and intention in the prenatal period to formula feed only (PR: 0.15, 95% CI: 0.10–0.22). In-hospital lactation support was associated with higher prevalence of in-hospital EBF (PR: 1.24, 95% CI: 1.16–1.33).
Conclusions:
Prioritizing lactation support for Black mothers, adolescent mothers, those intending in the prenatal period to formula feed only, and mother–infant dyads with certain medical factors could improve in-hospital EBF.
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