Paper Session E2: Promoting Health Across the Life Course: Focus on Special Populations Factors Associated with Exclusive Breastfeeding 2-4 Weeks Following Discharge from a Large Urban Academic Medical Center Striving for Baby-Friendly Designation

Background: Substantial evidence exists documenting the superiority of breastfeeding for mothers and breast milk for babies. Although the American Academy of Pediatrics and the US Healthy People 2010 initiative promote breastfeeding, current breastfeeding rates often fall short of recommendations. The care practices of the setting in which a woman gives birth may affect breastfeeding initiation and continuation. Positive breastfeeding outcomes have been reported at healthcare settings where a number of the "Ten Steps of the UNICEF-WHO Baby Friendly Hospital Initiative (BFI)" are in place. Purpose: To determine factors associated with exclusive breastfeeding 2-4 weeks following discharge from a large urban academic medical center striving for Baby-Friendly recognition. Methods: A convenience sample of all mothers who were breastfeeding at discharge (either exclusively or a combination of breast/bottle) within a one month time frame were contacted by telephone or email 2-4 weeks after discharge and invited to complete a survey containing items about their birth and early feeding experiences while in the hospital and after discharge. Mothers had the option of either responding to a telephone interview or completing the survey online using Survey Monkey. Response rates were comparable for the two methods with over 50 percent of the eligible mothers responding to the survey. Descriptive and inferential statistics were used to describe feeding behaviors and determine factors associated with exclusive breastfeeding 2-4 weeks after discharge. Results: Data were collected from 113 mothers (mean age=34, SD=4.6). At 2-4 weeks post-discharge, 88% were still breastfeeding (60% exclusively). The strongest contributor to exclusive breastfeeding after discharge was breastfeeding within the 1st hour after birth. Mothers who reported breastfeeding within the 1st hour of birth (61%) were significantly more likely to be exclusively breastfeeding at 2-4 weeks post-discharge (chi square = 8.04, p = .005). This was true for mothers who had vaginal (61%) or cesarean births (38%). The main reason for supplementing and weaning was perception of not enough milk.