The impact of baby-friendly hospital designation, employment status, parity, and other social-ecological factors on lactation duration for new mothers in upstate New York

The purpose of this study, that analyzed the existing Feeding Your Infant (FYI) dataset, was to examine the impact of Baby-Friendly (BF) Hospital designation, employment, parity, and other social-ecological factors on lactation status at three months postpartum in upstate New York. The FYI dataset was analyzed using an adapted version of the Bronfenbrenner Social-Ecological Systems Framework. A convenience sample of 842 breastfeeding mothers was surveyed at baseline between two sites – one a BF designated hospital, and one a community-based hospital with a mature breastfeeding program. Of the 515 mothers who returned the three month survey, 409 (79.4%) were still breastfeeding. Using t-tests, Chi square, multiple correspondence analysis and multiple logistic regression analysis, the following findings were reported: Maternal age of 31 to 35 years, women with 16 or more years of education, and married women, were statistically more likely to be breastfeeding at three months postpartum than younger, unmarried, and less educated women. In addition, mothers who reported a history of "mastitis and/or breast infection," and those who expected a maternity leave greater than 3 months, were also more likely to be breastfeeding. Those who had a prior live birth, who reported having a "not fussy" baby, and those who associated breastfeeding with "convenience" were more likely to be breastfeeding. A mother's race, parity status, expected amount of paid maternity leave, perception of having a "sleepy baby," experience with engorgement, experience with sore and/or bleeding nipples, and a mother's delivery site, whether BF designated or not, were not statistically significant. Within the multiple logistic regression analysis, predictors of breastfeeding status at three months postpartum were: insufficient milk, the perception of "too much time," and mothers' educational level.

In light of "The 2011 U.S. Surgeon's Call to Action to Support Breastfeeding," and the growing interest in The Ten Steps to Successful Breastfeeding and the WHO/UNICEF Baby-Friendly Hospital Initiative, these findings have important implications for education, practice, policy, and future research.