258153 Association between intrapartum practices and breastfeeding duration among Hong Kong mothers

Wednesday, October 31, 2012

Dorothy Li Bai, MBBS , School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
Kendra M. Wu, MSE MMedSc , School of Public Health, University of Hong Kong, Hong Kong, Hong Kong
Daniel Yee Tak Fong, PhD , School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
Marie Tarrant, RN MPH PhD , School of Nursing, University of Hong Kong, Hong Kong, Hong Kong
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.

Learning Areas:
Public health or related education
Public health or related nursing
Public health or related public policy
Public health or related research

Learning Objectives:
1. To examine exposure to different intrapartum practices among mothers delivering in public hospitals in Hong Kong 2. To assess the impact of intrapartum practices on the duration of both any and exclusive breastfeeding.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a co-investigator on this project and have participated in the data analysis and synthesis of the study findings. Among my scientific interests have been factors associated with breastfeeding and policies to improve breastfeeding.
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.