Factors influencing the practice of exclusive breastfeeding among Hong Kong Chinese women: a questionnaire survey

Aims and objectives. The purpose of this article is to explore the relationships between breastfeeding knowledge, self-efficacy and demographic factors on breastfeeding patterns among Hong Kong Chinese primiparous women. Background. There is substantial evidence showing that maternal education, social class, ethnic background and religion are related to the decision to initiate as well as continue breastfeeding. Nevertheless, not much is known about how the controllable factors are able to influence the practice with the Hong Kong Chinese population. Design. A cross-sectional and correlational design. Methods. A convenience sample of 82 subjects who had normal vaginal delivery in the maternity unit of a regional hospital in Hong Kong was recruited. Results. Linear regression analysis showed that subjects who lived with their mothers-in-law, had higher household income and higher gravida would be associated with a higher score in the Breastfeeding Self-Efficacy Scale. On the other hand, decisions to breastfeed made later in the pregnancy, father-in-law to 'pei-yue' (the Chinese practice whereby the new mother is expected to stay at home and to avoid all household chores and social activities during the first month after giving birth) and older in age would be associated with a lower score. Pei-yue is Chinese ritual of which the woman who has delivered should stay at home for one month and being taken care by others (this Chinese term is used throughout the article to indicate the time period described). Generalised estimating equations model revealed that women who had searched through the Internet for breastfeeding information, who had husbands to 'pei yue', lived in private housing, were married, had a domestic helper to 'pei yue' and who had attained higher education were more likely to practice exclusive breastfeeding. Conclusion. The social support from the family and breastfeeding self-efficacy have implications for continuing the practice of breastfeeding for primiparous women. Relevance to clinical practice. Future efforts aimed at promoting exclusive breastfeeding could include the modifiable factors into consideration to better tailor interventions for successful, exclusive breastfeeding.