Breastfeeding practices in an Australian tertiary care hospital: A retrospective study

Background: The World Health Organization recommend that infants be exclusively breastfed until six months of age. The Baby Friendly Health Initiative (BFHI) was developed for protecting, promoting, and supporting breastfeeding. The BFHI global criteria guides hospital practice for supporting infant feeding and reducing disparities in breastfeeding outcomes. Aim: The aim of this study was to analyse 2019 data to identify factors that predict exclusive breastfeeding vs non-exclusive breastfeeding on discharge to determine areas for intervention in relation to BFHI guidelines. Material and Methods: A retrospective chart review of 5836 neonates born at an Australian tertiary hospital in 2019 was conducted. Descriptive statistics were used to report exclusive breastfeeding rates. Univariate and logistic regression analyses were conducted to determine factors associated with exclusive breastfeeding and non-exclusive breastfeeding on discharge. Results: A total of 69% of neonates were exclusively breastfed on discharge in 2019. When excluding admissions to Newborn Services, 75% of neonates were exclusively breastfed on discharge, achieving the BFHI benchmark. Predictors which significantly reduced the odds of exclusive breastfeeding on discharge were maternal country of birth (Vietnam, p < 0.001, Sudan p < 0.001, Samoa p < 0.01, Philippines p < 0.05), main language (Other, p < 0.05), birth type (caesarean or assisted vaginal birth p < 0.001), first-feed type (mixed feeding or formula p < 0.001), and Newborn Services admission (p < 0.001). Conclusions: Examining breastfeeding outcomes is an important quality assurance process for health services. Understanding groups of mothers who commence breastfeeding but do not exclusively breastfeed upon discharge enables identification of areas for intervention to achieve BFHI targets and reduce breastfeeding disparities.