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Abstract:  Background:  An understanding of patterns of breastfeeding is necessary for the effective implementation of breastfeeding promotion and intervention programs. In Hong Kong, little current data have been gathered on women's breastfeeding rates. The objective of this study was to determine how patterns of breastfeeding, maternal demographics, and maternal employment affect continuation of breastfeeding in primiparous women in Hong Kong.

Method:  A longitudinal self-report survey was used to collect data when first-time mothers (n = 218) were in the hospital, at 1, 3, 6, 9, and 12 months postpartum, or until they weaned their infant. All data (self-report survey, demographic data, and follow-up telephone surveys) were collected in Cantonese and then translated into English. Data were analyzed by determining, first, the influence of individual variables on the length of breastfeeding using a simple Cox regression analysis, and second, by grouping variables according to time sequence and entering them into a Cox regression model in 4 sequential phases.

Results:  Factors that were significantly associated with continuation of breastfeeding were maternal age (HR = 0.97; p = 0.048); attendance at a prenatal breastfeeding class (HR = 0.69; p = 0.020); intended weeks of breastfeeding (HR = 0.97; p < 0.001); breastfeeding score in hospital (HR = 0.99; p = 0.009); and length of exclusive breastfeeding (HR = 0.93; p < 0.001). Similar results were obtained in the multiphase Cox regression analysis; only the breastfeeding score in hospital became marginally insignificant (p = 0.053) after adjusting for demographics, prenatal, and other immediate postpartum factors.

Conclusions:  Short periods of exclusive breastfeeding and early supplementation were common in this sample. Unlike previous research, maternal employment was not a statistically significant factor in length of continued breastfeeding. Study findings show that multiple factors influence continued breastfeeding in Hong Kong, suggesting further areas for investigation. Changes in practice may improve continued and exclusive breastfeeding rates. (BIRTH 30:3 September 2003)