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Does Postpartum Length of Stay Affect Breastfeeding Duration? A Population-Based Study


  • Katherine E. Heck MPH,

    1. 1Katherine Heck was with the National Center for Health Statistics and the California Department of Health Services at the time of this study; she is now with the 4-H Center for Youth Development at the University of California, Davis.
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  • Kenneth C. Schoendorf MD MPH,

    1. 2Kenneth Schoendorf is with the National Center for Health Statistics, Hyattsville, Maryland;
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  • Gilberto F. Chávez MD MPH,

    1. 3Gilberto Chávez is with the Centers for Disease Control and Prevention, Sacramento;
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  • Paula Braveman MD MPH

    1. 4Paula Braveman is with the University of California, San Francisco, California.
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Katherine E. Heck, MPH, Associate Specialist, 4-H Center for Youth Development, University of California, Davis, 3321 Hart Hall, Davis, CA 95616.


Abstract: Background: Short postpartum hospital stays may leave inadequate time for women to receive assistance with breastfeeding. Women leaving the hospital early may also have household responsibilities that could interfere with breastfeeding. This study examined the relationship between postpartum length of stay and breastfeeding cessation.

Methods: This study used data from 10,519 respondents to the California Maternal and Infant Health Assessment (MIHA) surveys from 1999 to 2001. MIHA is an annual statewide stratified random sample, population-based study of childbearing women in California. Survival analysis was used to examine the relationship between length of stay and length of time breastfeeding. Women were asked about the number of nights their infant stayed in the hospital at birth, whether they breastfed, and if so, the age of the child when they stopped. Hospital stay was defined in three categories: standard (2 nights for a vaginal delivery, 4 nights for a cesarean section), or shorter or longer than the standard stay.

Results: Approximately 88 percent of women initiated breastfeeding. Unadjusted predictors of breastfeeding cessation included short or long postpartum stay; young maternal age; Hispanic, African American, or Asian/Pacific Islander race/ethnicity; being unmarried; low income or education level; primiparity; being born in the 50 United States or the District of Columbia; smoking during pregnancy; and low infant birthweight. After adjustment for potential confounders, women with a short stay remained slightly more likely to terminate breastfeeding than women with a standard stay (relative risk, 1.11, 95% confidence interval 1.01, 1.23).

Conclusion: Women who leave the hospital earlier than the standard recommended stay are at somewhat increased risk of terminating breastfeeding early. (BIRTH 30:3 September 2003)