Influencing factors of early breastfeeding status – a retrospective analysis of 4200 mother-and-child-pairs of the University Hospital Basel, Switzerland, between 2014 – 2015

Introduction:

Benefits of breastfeeding are well researched. WHO recommends exclusive breastfeeding (EBF) for up to 6 months. In Switzerland, breastfeeding rates have yet not met these recommendations therefore warrant further promotion. In this study we identify and understand influencing factors of breastfeeding behaviour within the first few days after childbirth as it is a crucial time for setting the course on breastfeeding practice.

Material and methods:

UNICEFs Baby-friendly-hospital-initiative data collection was used and retrospectively analysed. We excluded mothers < 18y, infants GA < 37w, transfers to NICU and outpatient births. Based on breastfeeding status at discharge, three study groups were formed: EBF, partial- (PBF) and non-breastfeeding (NBF) group. Maternal, infant and institutional variables were divided. Univariate and multivariate regression analysis was performed.

Results:

Univariate analysis showed following variables' significant (p < 0.001) correlation to PBF and NBF: (gestational-)diabetes (GDM/DM), diabetic fetopathy, IUGR, early term births (< 39w), delayed bonding (≥1h pp), short bonding duration, delayed first feed (> 2h pp), separation of mother and child, use of aids (pacifier). Multivariate regression analysis showed inverted nipples (OR 5.4), request for formula (OR 5.3), DM/GDM (OR 5.1), multiples (OR 6.9) and use of breast-pump (OR 5.3) to be strongest predictors for PBF-practice.

Conclusion:

Immediate bonding after birth and early breastfeeding initiation should be provided. Supplemental formula feeding for infants with diabetic mothers, should strongly be reconsidered. Routine formula feeding must be avoided. Identify risk factors that may impact the ability to breastfeed effectively and provide affected mother-and-child-pairs with appropriate assistance.