Association between intrapartum practices and breastfeeding duration among Hong Kong mothers

Few Hong Kong mothers exclusively breastfeed and one-half stop breastfeeding within the first two months. There is little research in this population on the association between intrapartum practices and breastfeeding duration. A sample of 1280 mother-infant pairs were recruited from the obstetric units of four public hospitals in Hong Kong and followed up prospectively for 12 months or until weaned. The outcome variables were the duration of any and exclusive breastfeeding. Predictor variables included receipt of opioid pain medication, labour type, epidural administration, delivery type, and experiencing a natural delivery. Participants were classified as having a natural delivery if they had a spontaneous vaginal delivery with no opioid pain medication or epidural administered. We used Cox regression to assess the impact of intrapartum practices on breastfeeding duration. The median duration of any and exclusive breastfeeding were 8 weeks and 2 weeks respectively. Bivariable analysis showed that receipt of opioid pain medication (HR=1.20; 95% CI 1.06 to 1.37), induction of labour (HR=1.24; 95% CI 1.09 to 1.41), and having an emergency cesarean section (HR=1.23; 95% CI 1.02 to 1.49) inversely affected the duration of breastfeeding; a natural delivery positively affected the duration of breastfeeding (HR=0.81; 95% CI 0.72 to 0.92). After controlling for known confounders, however, there was no longer an association between intrapartum practices and the duration of any or exclusive breastfeeding. Therefore, while intrapartum practices can impede breastfeeding initiation and duration, other factors social and cultural factors may be more critical in determining breastfeeding duration among Hong Kong mothers.