Maternity ward staff perceptions of exclusive breastfeeding in Finnish maternity hospitals: A cross-sectional study

Abstract

INTRODUCTION This study aimed to describe exclusive breastfeeding (EBF, Step 6 of the Baby-Friendly Hospital Initiative) in Finnish maternity hospitals and identify factors that promote or limit EBF. METHODS A cross-sectional study design was used, and data were collected from eight maternity hospitals in Finland during a 10-day period in May 2014. The staff completed questionnaires (n=1554) from separate work shifts. The data were analyzed using descriptive statistics, and chi-squared and Fisher's tests. Responses to open-ended questions were analyzed using content analysis. RESULTS Maternity ward staff reported that 72% (n=1105) of the infants were exclusively breastfed during their work shift. The strongest promoting factors of exclusive breastfeeding were: maternity ward staffs' profession and education in breastfeeding counselling; multiparity; vaginal delivery; early skin-to-skin contact between mother and infant; initial breastfeeding after birth; rooming-in; and initial success of breastfeeding. The use of a nipple shield, the need for additional breastfeeding counselling, and infants' blood tests were limiting factors to exclusive breastfeeding. Open-ended answers revealed that exclusive breastfeeding was mainly delayed because of medical issues for the mother or infant. CONCLUSIONS Finnish maternity hospitals could improve exclusive breastfeeding rates by focusing attention and resources on breastfeeding counselling and evidence-based maternity care practices related to immediate care after birth, promoting vaginal delivery, rooming-in and availability of skilled counselling.

The Effect of a Structured Individualized Educational Intervention on Breastfeeding Rates in Greek Women

“…Midwifes could influence and increase breastfeeding rates by training women how to understand the whole process and nature of breastfeeding, outcomes that have been proved similarly and in our study using our intervention protocol [15,[55][56][57][58]. More specifically, individualized education in low-risk women and women with endocrine diseases of midwifery staff as in our study, proved to be effective in accordance with the published evidence, as it reduces the likelihood of cessation of breastfeeding, and increases women's knowledge, skills and confidence in breastfeeding [39,59].…”

“…Personalized education and support are likely to increase breastfeeding initiation, exclusivity and duration rates [37][38][39]. Previous studies showed that social factors and targeted intervention in the prenatal or postnatal period might have a positive effect on the onset and duration of breastfeeding, increase confidence in breastfeeding and provide women with adequate knowledge about breastfeeding and increase exclusive breastfeeding [40][41][42][43][44][45][46][47][48][49].…”

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

“…Therefore, it is not surprising that a higher proportion of mothers, even for those with cesarean delivery, reported that they had skin-to-skin contact immediately after birth, rooming-in with their infants, breastfeeding initiation within the first hour and EBF during hospitalization in our study. These interventions have all been shown to be strong contributors to establishment and continuation of breastfeeding [ 7 , 14 – 17 ].…”

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

“…Therefore, it is not surprising that a higher proportion of mothers, even for those with cesarean delivery, had skin-to-skin contact immediately after birth, rooming-in with their infants, breastfeeding initiation within the rst hour and EBF during hospitalization in this survey. These interventions have been shown to be strong contributors to establishment and continuation of breastfeeding [11,[17][18][19][20].…”

“…The lack of associations of other variables with EBF within six months may be due to the fact that the majority of surveyed mothers were employed and had breastfeeding initiation within the rst hour. As for mode of delivery, previous studies have suggested that women with cesarean delivery were less likely to EBF than those with vaginal delivery [6,17]. Delayed onset of lactation, disrupted mother-infant interaction, inhibited infant suckling and poor pain relief may mediate the effects of caesarean delivery on breastfeeding [25].…”