The influence of some factors on the rate of exclusively breastfed infants at the time of hospital discharge in 2000-2004
Abstract
Purpose: To identify potential factors influencing the exclusive breastfeeding at the time of hospital discharge in the Czech Republic from 2000 through 2004. Methods: Data from 466 731 infants born from 2000 through 2004 was collected retrospectively from newborn reports and statistically analyzed.
Results: The average rate of exclusive breastfeeding was 90.6 % at the time of hospital discharge throughout the whole study period. Statistically significant decrease in probability that an infant would not be exclusively breastfed at the time of hospital discharge was identified in several risk factors.
The risk factors belonging to demographic factors include low maternal age (82.4% exclusively breastfed = EB), low education level (83.6% EB) and a mother living without a mate (87.1% EB). Factors relating to pregnancy encompass: multiple gestation (for twins 61.5% EB and for triplets and more infants 24.1% EB) and in vitro fertilization (72.2% EB).
The risk perinatal factors concerned of delivery by caesarean section (79.4% EB) and the analgesia usage duringdelivery. The highest risk related to analgesia were represented by general anesthesia (78.7% EB), then spinal anesthesia (80.3% EB for section and 86.3% EB for vaginal delivery) and the least risk was represented by epidural anesthesia (81.6% EB for section and 90.86% EB for vaginal delivery).
Too short (3 days-83.9% EB) or too long hospital stay (more than 7 days -85.1% EB) also negatively influenced breastfeeding. The other identified risk factors include low birth weight and diagnosis of hypotrophic infant (71.6% EB) or congenital abnormality (79.4% EB).
From 2000 through 2004 the risk that an infant will not be exclusively breastfed statistically increased in the group of mothers with low educational level (RR 2000 = 1.45, RR 2004 = 1.65) and in the group of infants with congenital abnormalities (RR 2000 = 1.93, RR 2004 = 2.96). On the contrary this risk decreased for a delivery by section (RR 2000 = 2.68, RR 2004 = 2.28).
Conclusion: In breastfeeding support it is necessary to focus on groups of mothers and infants with identified risk factors