Department of Women's Health, University of Texas at Austin Dell Medical School, Austin, Texas, USA.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.
Breastfeed Med. 2022 Jul;17(7):584-592. doi: 10.1089/bfm.2021.0324. Epub 2022 Apr 11.
The Baby Friendly Hospital Initiative has had a positive impact on breastfeeding initiation; however, little is known about posthospital infant feeding practices among women who deliver at baby friendly hospitals. Therefore we sought to evaluate posthospital breastfeeding outcomes among women who deliver at a baby friendly hospital (BFH) by (1) estimating exclusive breastfeeding rates at the postpartum visit (PPV), (2) quantifying the exclusive breastfeeding discontinuation rate, and (3) identifying which factors are associated with breastfeeding discontinuation. This was a prospective cohort study of women aged 14 and over, who delivered at the University of Alabama at Birmingham. The primary outcome was mode of infant feeding categorized as exclusive breastfeeding (EBF), combination breastfeeding and formula feeding (CF), and exclusive formula feeding (EFF) at the PPV. Secondary outcome was EBF discontinuation rate. Patients who initiated formula and/or who stopped breastfeeding were asked what influenced their decision. At hospital discharge, 71.1% of the participants were EBF, 21.7% were CF, and 7.2% were EFF. At the PPV, the frequency of the primary outcome of EBF was 31.6% (95% confidence interval: 25.2-38.8); 34.6% (28.0-41.9) were CF, and 33.8% (27.3-41.1) were EFF. Therefore, the EBF absolute and relative discontinuation rates were 39.5% and 55.6%, respectively. No demographic factors, delivery characteristics, or maternal medical morbidities were associated with EBF in the multivariable logistic regression. However, women in the EBF group were more likely to report a workplace environment conducive to breastfeeding and partner and friend support. Significant breastfeeding discontinuation rates occur even among women who deliver at a BFH. Our findings suggest that multifactorial interventions, including a focus on the prevention of formula introduction, are needed in the early postpartum period to achieve higher EBF rates at the PPV.
婴儿友好医院倡议对母乳喂养的启动产生了积极影响；然而，对于在婴儿友好医院分娩的妇女在出院后的婴儿喂养实践知之甚少。因此，我们试图通过以下方法评估在婴儿友好医院（BFH）分娩的妇女在出院后的母乳喂养结果：（1）估计产后访视时的纯母乳喂养率；（2）量化纯母乳喂养中断率；（3）确定哪些因素与母乳喂养中断有关。这是一项对在阿拉巴马大学伯明翰分校分娩的 14 岁及以上妇女进行的前瞻性队列研究。主要结局是婴儿喂养模式，分为纯母乳喂养（EBF）、混合母乳喂养和配方奶喂养（CF）和纯配方奶喂养（EFF）。次要结局是 EBF 中断率。对于开始使用配方奶和/或停止母乳喂养的患者，询问他们的决定受到哪些因素影响。在出院时，71.1%的参与者为 EBF，21.7%为 CF，7.2%为 EFF。在产后访视时，主要结局 EBF 的频率为 31.6%（95%置信区间：25.2-38.8）；34.6%为 CF，33.8%为 EFF。因此，EBF 的绝对和相对中断率分别为 39.5%和 55.6%。在多变量逻辑回归中，没有任何人口统计学因素、分娩特征或产妇医疗合并症与 EBF 相关。然而，在 EBF 组中，更多的妇女报告工作场所环境有利于母乳喂养，以及伴侣和朋友的支持。即使在在 BFH 分娩的妇女中，也会发生显著的母乳喂养中断。我们的发现表明，在产后早期需要采取多因素干预措施，包括重点预防配方奶的引入，以提高产后访视时的 EBF 率。
