School of Nursing, University of Hong Kong.
Birth. 2011 Sep;38(3):238-45. doi: 10.1111/j.1523-536X.2011.00483.x. Epub 2011 May 20.
The World Health Organization (WHO) developed the Baby-Friendly Hospital Initiative to improve hospital maternity care practices that support breastfeeding. In Hong Kong, although no hospitals have yet received the Baby-Friendly status, efforts have been made to improve breastfeeding support. The aim of this study was to examine the impact of Baby-Friendly hospital practices on breastfeeding duration.
A sample of 1,242 breastfeeding mother-infant pairs was recruited from four public hospitals in Hong Kong and followed up prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for 8 weeks or less. Predictor variables included six Baby-Friendly practices: breastfeeding initiation within 1 hour of birth, exclusive breastfeeding while in hospital, rooming-in, breastfeeding on demand, no pacifiers or artificial nipples, and information on breastfeeding support groups provided on discharge.
Only 46.6 percent of women breastfed for more than 8 weeks, and only 4.8 percent of mothers experienced all six Baby-Friendly practices. After controlling for all other Baby-Friendly practices and possible confounding variables, exclusive breastfeeding while in hospital was protective against early breastfeeding cessation (OR: 0.61; 95% CI: 0.42-0.88). Compared with mothers who experienced all six Baby-Friendly practices, those who experienced one or fewer Baby-Friendly practices were almost three times more likely to discontinue breastfeeding (OR: 3.13; 95% CI: 1.41-6.95).
Greater exposure to Baby-Friendly practices would substantially increase new mothers' chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines.
世界卫生组织（WHO）制定了《促进母乳喂养成功的十点措施》和《国际母乳代用品销售守则》，以改善医院产科护理实践，支持母乳喂养。在香港，虽然没有医院获得“爱婴医院”的称号，但已经在努力改善母乳喂养的支持。本研究的目的是检验爱婴医院实践对母乳喂养持续时间的影响。
从香港四家公立医院招募了 1242 对母乳喂养的母婴对，并前瞻性随访了 12 个月。主要结局变量定义为母乳喂养 8 周或更短时间。预测变量包括六项爱婴医院措施：出生后 1 小时内开始母乳喂养、住院期间纯母乳喂养、母婴同室、按需母乳喂养、不使用奶嘴或人工乳头、出院时提供母乳喂养支持小组的信息。
只有 46.6%的女性母乳喂养时间超过 8 周，只有 4.8%的母亲经历了所有六项爱婴医院措施。在控制了所有其他爱婴医院措施和可能的混杂变量后，住院期间纯母乳喂养可预防早期母乳喂养停止（OR：0.61；95%CI：0.42-0.88）。与经历了所有六项爱婴医院措施的母亲相比，经历了一项或更少爱婴医院措施的母亲中断母乳喂养的可能性几乎增加了三倍（OR：3.13；95%CI：1.41-6.95）。
更多地接触爱婴医院措施将大大增加新妈妈产后母乳喂养 8 周以上的机会。为了进一步改善医院的产科护理实践，需要机构和行政支持，以确保所有母亲都能按照世卫组织的指导方针获得足够的母乳喂养支持。
