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A mixed-methods study on the association of six-month predominant breastfeeding with socioecological factors and COVID-19 in experienced breastfeeding women in Hong Kong

This article was originally published here

Int Breastfeed J. 2022 May 21;17(1):40. doi: 10.1186/s13006-022-00484-7.

ABSTRACT

BACKGROUND: Over the past decade, various breastfeeding policies have been implemented in Hong Kong, including changes to perinatal guidelines in government hospitals, adoption of the Baby Friendly Hospital Initiative (BFHI), providing guidelines for the marketing of infant formula, criminalizing discrimination towards breastfeeding and extending statutory maternity leave. Meanwhile, the COVID-19 pandemic has brought new challenges and opportunities to breastfeeding practices. Infection control measures at public hospitals included canceling prenatal classes, hospital visits and postnatal classes; suspension of periods of perinatal visits; and mandatory separation of COVID-19 positive mothers from newborns. In addition, work-from-home policies have been widely implemented. This study aimed to identify factors associated with predominant breastfeeding (PBF) for six months and to assess the impact of COVID-19 on breastfeeding practice.

Methods: This study was conducted from March 1, 2021 to April 7, 2021 using a mixed methods approach. An electronic questionnaire was distributed to members of breastfeeding or parenting groups who had breastfeeding experience in the past 10 years. Logistic and linear regression analyzes were conducted to identify factors associated with six-month FBP both in general and during the pandemic period. A qualitative content analysis was conducted using an inductive approach.

RESULTS: The study included 793 participants. Delivery in a public hospital (OR 2.21; 95% CI 1.46, 3.34) and breastfeeding support from family and friends (OR 1.28; 95% CI 95% 1.05, 1.57) were significantly associated with six-month FBP, even during COVID-19. Factors associated with the self-rated impact of COVID-19 on breastfeeding include working from home, the perceived immunological benefits of breastfeeding, and the desire to avoid breastfeeding or expressing breast milk in public places. In addition, breastfeeding practice in public hospitals was more likely to be affected by staff activity, while private hospitals had poorer cohabitation practices and staff who had insufficient knowledge about breastfeeding. ‘feeding with milk.

CONCLUSIONS: Delivery in a public hospital and breastfeeding support from family and friends were associated with six-month FBP. Additionally, COVID-19 in Hong Kong had an overall positive impact on six-month PBF. Further studies should investigate the impact of hospital practices and the COVID-19 pandemic on breastfeeding behaviors.

PMID:35597945 | DO I:10.1186/s13006-022-00484-7