204178 Impact of baby-friendly hospital practices on breastfeeding in Hong Kong

Wednesday, November 11, 2009: 12:45 PM

Marie Tarrant, RN MPH PhD , Department of Nursing Studies, University of Hong Kong, Hong Kong, Hong Kong
Kendra M. Wu, BSE MSE MMedSc , School of Public Health, University of Hong Kong, Hong Kong, Hong Kong
Daniel Yee Tak Fong, PhD , Department of Nursing Studies, University of Hong Kong, Hong Kong, Hong Kong
Irene Lai Yin Lee, RN RM MHA MPHC , Departmental Operations Manager, Departmental of Obstetrics and Gynaecology, Queen Mary Hospital, Hong Kong, Hong Kong
Emmy Man Yee Wong, RN MN PhD , School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong
Alice Sham, RN RM MSc MBA , General Manager Nursing, Kwong Wah Hospital, Kowloon, Hong Kong
Christine Lam, RN RM MMW IBCLC , Nurse Specialist (Lactation), Departmental of Obstetrics and Gynaecology, Queen Elizabeth Hospital, Kowloon, Hong Kong
Joan E. Dodgson, RN MPH PhD , College of Nursing and Healthcare Innovation, Arizona State University, Phoeniz, AZ
The World Health Organization (WHO) developed the Baby-Friendly Hospital Initiative to improve hospital maternity-care practices that support breastfeeding. In Hong Kong, while 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 1189 breastfeeding mother-infant pairs was recruited from four public hospitals in Hong Kong and followed prospectively for up to 12 months. The primary outcome variable was defined as breastfeeding for ≤8 weeks. 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 upon discharge. Only 45.8% of women breastfed for >8 weeks and only 5% 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=0.63; 95% CI 0.44 to 0.92). Compared with mothers who experienced all six baby-friendly practices, mothers who experienced ≤1 baby friendly practice were almost five times more likely to discontinue breastfeeding (OR=4.49; 95% CI 2.15 to 9.38). Greater exposure to baby-friendly practices would substantially increase Hong Kong women's chances of breastfeeding beyond 8 weeks postpartum. To further improve maternity care practices in Hong Kong hospitals, institutional and administrative support are required to ensure all mothers receive adequate breastfeeding support in accordance with WHO guidelines.

Learning Objectives:
1. To determine the exposure to baby-friendly practices among mothers delivering in public hospitals in Hong Kong. 2. To determine the impact of baby-friendly practices on breastfeeding duration in Hong Kong.

Keywords: Breastfeeding, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Principal Investigator
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.