Factors Influencing Breastfeeding Practices for Women at Discharge in a Regional Hospital in Australia.

BACKGROUND: Most data investigating factors influencing exclusive breastfeeding in Australia is metropolitan based. AIM: This study aims to evaluate how maternal, birth, and neonatal characteristics relate to exclusive breastfeeding at discharge at a regional Australian hospital. METHODS: This was a retrospective observational study of perinatal data from 2018 to 2022. Exclusion criteria included maternal mastectomy, unknown breastfeeding status at discharge, maternal medications precluding breastfeeding and preterm birth. Univariate and multivariate analyses were completed against the outcome of breastfeeding status at discharge. Breastfeeding status was determined by recorded feeding status at discharge, which may not reflect feeding practices during the admission. RESULTS: There were 14,291 eligible participants including 11,612 (81%) who exclusively breastfed at discharge, and 2679 (19%) who did not. Statistically significant (p < 0.05) factors demonstrated a lower likelihood to exclusively breastfeed on discharge with higher maternal BMI (aOR = 0.96, 95% CI [0.95, 0.97]), not intending to breastfeed during the pregnancy (aOR = 0.07, 95% CI [0.06, 0.08]), smoking in pregnancy (aOR = 0.68, 95% CI [0.59, 0.79]), prior breast surgery (aOR = 0.84, 95% CI [0.71, 1.00]), not having midwifery-based antenatal care (aOR = 0.68, 95% CI [0.61, 0.76]), higher antenatal EPDS score (aOR = 0.97, 95% CI [0.96, 0.99]), Caesarean birth (aOR = 0.53, 95% CI [0.48, 0.60]), > = 60 minutes from birth to the first feed (aOR = 0.71, 95% CI [0.63, 0.80]), unplanned pregnancy (aOR = 0.88, 95% CI [0.78, 0.98]), birth weight < 2500 g (aOR = 0.51, 95% CI [0.39, 0.69]), nursery admission (aOR = 0.54, 95% CI [0.47, 0.62]) and no skin-to-skin at birth (aOR = 0.78, 95% CI [0.66, 0.92]). CONCLUSION: Considering these factors while designing breastfeeding interventions may allow for a more targeted and person-centered approach.