The October 2008 issue of Pediatrics has a supplement devoted to the topic of breastfeeding. Among the many articles was a study of how maternity care practices affect breastfeeding. The study used recent CDC data on infant feeding practices (Infant Feeding Practices II).
The researchers found a strong association between "Baby-Friendly" practices and longer duration of breastfeeding. Mothers who experienced no Baby-Friendly practices, compared to mothers who received all six that the study examined, were thirteen times more likely to stop breastfeeding early. The most significant practices were initiation of breastfeeding within the baby's first hour of life, giving only breast milk, and not using pacifiers.
Below is the abstract from the study; email me if you'd like the full text of the article.
Effect of Maternity-Care Practices on Breastfeeding
Ann M. DiGirolamo, PhD, MPH, Laurence M. Grummer-Strawn, PhD and Sara B. Fein, PhD.
Pediatrics 122 (2008): S43-S49
OBJECTIVE. Our goal was to assess the impact of "Baby-Friendly" hospital practices and other maternity-care practices experienced by mothers on breastfeeding duration.
METHODS. This analysis of the Infant Feeding Practices Study II focused on mothers who initiated breastfeeding and intended prenatally to breastfeed for >2 months, with complete data on all variables (n = 1907). Predictor variables included indicators of 6 "Baby-Friendly" practices (breastfeeding initiation within 1 hour of birth, giving only breast milk, rooming in, breastfeeding on demand, no pacifiers, fostering breastfeeding support groups) along with several other maternity-care practices. The main outcome measure was breastfeeding termination before 6 weeks.
RESULTS. Only 8.1% of the mothers experienced all 6 "Baby-Friendly" practices. The practices most consistently associated with breastfeeding beyond 6 weeks were initiation within 1 hour of birth, giving only breast milk, and not using pacifiers. Bringing the infant to the room for feeding at night if not rooming in and not giving pain medications to the mother during delivery were also protective against early breastfeeding termination. Compared with the mothers who experienced all 6 "Baby-Friendly" practices, mothers who experienced none were 13 times more likely to stop breastfeeding early. Additional practices decreased the risk for early termination.
CONCLUSIONS. Increased "Baby-Friendly" hospital practices, along with several other maternity-care practices, improve the chances of breastfeeding beyond 6 weeks. The need to work with hospitals to implement these practices continues to exist, as illustrated by the small proportion of mothers who reported experiencing all 6 of the "Baby-Friendly" hospital practices measured in this study.