Exclusive breastfeeding rate and related factors among mothers within maternal health WeChat groups in Jiaxing, Zhejiang province, China: A cross-sectional survey

Abstract

Background The benefits of exclusive breastfeeding (EBF) in the first six months are well recognized, but the EBF rate is still lower in China. WeChat, a most widely used communication application in China, is now used for maternal health education and management in Jiaxing, Zhejiang province, China. The aim of this study was to assess the EBF rate and its associated factors among the mothers within the maternal health WeChat groups. Methods This was a cross-sectional survey on healthy mothers with infants aged 7-12 months from seven maternal health WeChat groups in Jiaxing, China. Data including breastfeeding practice in the first six months, maternal sociodemographic and obstetric characteristics, hospitalization information, work related factors and reasons for non-EBF were collected using an online self-administered questionnaire in October 2021. A multivariable logistic regression analysis was performed to identify the factors independently associated with EBF in the first six months. Results A total of 822 mothers were included in this study. Among them, 586 mothers exclusively breastfed their infants until six months with a EBF rate of 71.3%. Multivariable logistic regression analysis indicated that maternal age (adjusted odds ratio, AOR: 0.948, 95% CI: 0.909-0.990) and perceived insufficient breast milk (AOR: 0.104, 95%CI: 0.072-0.150) were negatively associated with EBF, while EBF during hospitalization was positively associated with EBF within six months (AOR: 2.889, 95% CI: 2.014-4.143). The five of common reasons for non-EBF were no or insufficient breast milk (59.8%), return to work (23.9%), no flexible nursing breaks at work (18.2 %), infant crying or feeling tired or troubled with breastfeeding (9.7%), and nipple and breast problems (9.3%). Conclusion The EBF rate is higher among the mothers within maternal health WeChat groups. WeChat group model can be used to be a cost-effective and useful measure to promote EBF in China. However, perceived insufficient breast milk and work related factors are still the main barriers to EBF in this setting.