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Birth. 2018 Dec;45(4):440-449. doi: 10.1111/birt.12345. Epub 2018 Mar 2.

Exclusive breastfeeding in hospital predicts longer breastfeeding duration in Canada: Implications for health equity.

Author information

1
Department of Pediatrics and Child Health, Health Sciences Centre, CE-208 Children's Hospital, University of Manitoba, Winnipeg, MB, Canada.
2
Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
3
Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
4
College of Nursing, University of Manitoba, Winnipeg, MB, Canada.
5
Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
6
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada.
7
Department of Pediatrics, Child & Family Research Institute and BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
8
Department of Medicine, McMaster University, Hamilton, ON, Canada.

Abstract

BACKGROUND:

Breastfeeding has many established health benefits for women and children. We examined the association between maternal education, newborn feeding in hospital, and long-term breastfeeding duration.

METHODS:

We studied 3195 Canadian mother-infant dyads in the CHILD pregnancy cohort. Newborn feeding was documented from hospital records. Caregivers reported sociodemographic factors and infant feeding at 3, 6, 12, 18, and 24 months.

RESULTS:

Overall, 97% of newborns initiated breastfeeding and 74% were exclusively breastfed in hospital. Exclusively breastfed newborns were ultimately breastfed longer compared with those who received formula supplementation during their hospital stay (median 11.0 vs 7.0 months, P < .001). After controlling for maternal age, ethnicity, birth mode, and gestational age, exclusively breastfed newborns had a 21% reduced risk of breastfeeding cessation (HR = 0.79, 0.71-0.87). This effect was strongest among women without a postsecondary education (HR = 0.65, 0.53-0.79).

DISCUSSION:

Exclusive breastfeeding in hospital is associated with longer breastfeeding duration, particularly among women of lower socioeconomic status. Initiatives that support exclusive breastfeeding of newborns in hospital could improve long-term breastfeeding rates and help reduce health inequities arising in early life.

KEYWORDS:

breastfeeding exclusivity and duration; hospital practices; maternal-child health equity; newborn feeding; perinatal care

PMID:
29498088
DOI:
10.1111/birt.12345

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