Published online October 1, 2008
PEDIATRICS Vol. 122 Supplement October 2008, pp. S43-S49 (doi:10.1542/peds.2008-1315e)

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SUPPLEMENT ARTICLE

Effect of Maternity-Care Practices on Breastfeeding

Ann M. DiGirolamo, PhD, MPH^a, Laurence M. Grummer-Strawn, PhD^b and Sara B. Fein, PhD^c

^a Hubert Department of Global Health, Emory University, Atlanta, Georgia
^b National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
^c Center for Food Safety and Applied Nutrition, Food and Drug Administration, US Department of Health and Human Services, College Park, Maryland

OBJECTIVE. Our goal was to assess the impact of "Baby-Friendly" hospital practices and other maternity-care practices experienced by mothers on breastfeeding duration.

METHODS. This analysis of the Infant Feeding Practices Study II focused on mothers who initiated breastfeeding and intended prenatally to breastfeed for >2 months, with complete data on all variables (n = 1907). Predictor variables included indicators of 6 "Baby-Friendly" practices (breastfeeding initiation within 1 hour of birth, giving only breast milk, rooming in, breastfeeding on demand, no pacifiers, fostering breastfeeding support groups) along with several other maternity-care practices. The main outcome measure was breastfeeding termination before 6 weeks.

RESULTS. Only 8.1% of the mothers experienced all 6 "Baby-Friendly" practices. The practices most consistently associated with breastfeeding beyond 6 weeks were initiation within 1 hour of birth, giving only breast milk, and not using pacifiers. Bringing the infant to the room for feeding at night if not rooming in and not giving pain medications to the mother during delivery were also protective against early breastfeeding termination. Compared with the mothers who experienced all 6 "Baby-Friendly" practices, mothers who experienced none were 13 times more likely to stop breastfeeding early. Additional practices decreased the risk for early termination.

CONCLUSIONS. Increased "Baby-Friendly" hospital practices, along with several other maternity-care practices, improve the chances of breastfeeding beyond 6 weeks. The need to work with hospitals to implement these practices continues to exist, as illustrated by the small proportion of mothers who reported experiencing all 6 of the "Baby-Friendly" hospital practices measured in this study.

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Key Words: breast feeding • maternity • hospital

Abbreviations: IFPS—Infant Feeding Practices Study

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Accepted Jun 4, 2008.

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