Decision to breastfeed and early cessation of breastfeeding in infants below 6 months old - a population-based study of 3,204 infants in Hong Kong

Breastfeeding rate has been low in Hong Kong over the last three decades. This has happened with concomitant rapid economic development and improved living standards. A population-based survey was conducted to evaluate factors influencing decision, duration and early cessation of breastfeeding in 3,204 full-term healthy infants under 6 months throughout Hong Kong in 1993. A self-administered questionnaire was used. The overall percentage of breastfed infants was particularly low (9.6%), 36.1% had already given up breastfeeding and were being formula-fed (FFBF), 54.3% have been exclusively formula-fed since birth. The proportion of breastfed infants in the 5(th) month was even lower than in the 1(st) month (4.2% vs. 14.7%). Mothers who sustained breastfeeding tended to have parity >= 2, were less educated, housewives and residing in Hong Kong < 5 years when compared to FFBF mothers (p < 0.009). Husbands had. a decisive role on wives initiating breastfeeding while health-professionals had an influence on early switching to FFBF (p < 0.003). More breastfeeding mothers perceived breastfeeding benefits than FFBF mothers (p < 0.03). The Cox proportional hazard model showed that mother's residency status >= 5-year (HR=2.4), working mothers (HR=1.5) and health-professionals' opinions (HR=1.5) were associated with an early cessation of breastfeeding (p < 0.001). However, strengthening immunity (HR=0.67) and parity >= 2 (HR=0.72) helped sustain breastfeeding (p < 0.001). To conclude, the proportion of breastfed infants was low in Hong Kong in the early 1990s. Major factors associated with the decision to breastfeed and early cessation of breastfeeding were identified which would help formulate an interdisciplinary approach for promotion of breastfeeding up-to 6 months and beyond.