A study of in-hospital midwifery practices that affect breastfeeding outcomes.

Whilst breastfeeding is undoubtedly best for both mother and baby, many factors influence a woman's decision about whether to start and when to cease feeding. This study sought to determine which variables, influenced by midwifery practice, may influence the length of breastfeeding. Mothers who had given birth to a live baby at a Perth private hospital were invited to complete a validated, anonymous questionnaire asking about their breastfeeding experience, both in hospital and following discharge. The response rate was 50% (n=266). Although 94% of women were breastfeeding on discharge from hospital, this rate reduced to 59% at 6 months and 21% at 12 months. The mean duration of breastfeeding was 7.4 months (SD +/- 4.1). Of five variables thought to be associated with an increased length of breastfeeding, only two were found to be statistically significant: whether a mother could independently attach the baby on discharge (p=0.003) and whether or not artificial baby milk was administered in hospital (p<0.001). In order to improve breastfeeding rates, education for both mothers and midwives must be targeted towards ensuring mothers are able to independently attach their baby on discharge from hospital. The findings also support the discouragement of artificial feeding unless there is a medical indication or the mother has made an informed request.