174260 Is Baby Friendly Status Essential for Optimal Postpartum Breastfeeding Care?

Monday, October 27, 2008: 9:15 AM

Ann M. Dozier, RN, PhD , Community and Preventive Medicine/Social and Behavioral Medicine, University of Rochester, Rochester, NY
Cindy R. Howard, MD, MPH , Pediatrics, Rochester General Hospital, Rochester, NY
Cynthia K. Childs, MFA, MPH , Pediatrics, University of Rochester, Rochester, NY
Hongmei Yang, PhD , Biostatistics and Computational Biology, University of Rochester, Rochester, NY
Ruth A. Lawrence, MD , Pediatrics, University of Rochester, Rochester, NY
Background: Among breastfeeding (BF) women, delivering in a Baby Friendly setting is known to increase BF duration. This prospective cohort study to ascertain BF duration among women delivering at two similarly sized hospitals (Baby Friendly (BFH) (n=429); community hospital (CH) (n=414) with a well established BF program).

Design/Methods: BF mothers with healthy term infants were interviewed postpartum, and surveyed at 2 weeks, 3 and 6 months assessing exclusivity and duration. Process evaluations assessed compliance with the Baby Friendly ten steps.

Results: Chi-square (bivariate) and Kaplan-Meier and Cox proportional hazards models (multivariate) demonstrated no significant differences between the hospitals' samples recruited. BFH evaluation showed strong implementation of nearly all baby friendly steps; CH had strong implementation of fewer steps. Survival analyses modeled duration of any BF at one and six months showing no significant differences between mothers recruited from the two hospitals. The model retained maternal education, confidence to BF, marital status, BF goal and post-discharge feeding plan as significant effects. Factors eliminated included maternal age, race, parity, lives with father of baby, previous BF and hospital BF experience (p>.05). The extent of censored data may have affected findings.

Conclusions: Compared to settings with minimal BF support, settings implementing Baby Friendly's ten steps increased BF duration among BF mothers. A setting with a well established BF support program that does not include all aspects of the ten steps may result in similar BF duration outcomes. Differences in exclusivity and cost between these two programs are under study.

Learning Objectives:
1. List the Baby Friendly Ten Steps. 2. Describe methods to evaluate programs that increase breastfeeding duration. 3. Interpret process and outcome results from Baby Friendly program evaluation.

Keywords: Breastfeeding, Hospitals

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the Principal Investigator for the study reported in this abstract
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.