Factors that prevent the discharge of newborns with exclusive breastfeeding from a baby friendly hospital

Factors that Prevent the Discharge of Newborns with Exclusive Breastfeeding from a Baby Friendly Hospital For the optimal growth and development of infants, exclusive breastfeeding until 6 months of age and continuation of breastfeeding until ≥2 years of age with the addition of complementary foods at 6 months are recommended by World Health Organization. Implementation of "10 Steps of Baby Friendly Hospital Initiative" that define how breastfeeding should be protected, promoted and supported in hospitals helps to increase breast feeding rates worldwide. In this study, the factors that hinder exclusive breastfeeding of infants from birth until discharge at Akdeniz University Hospital, which is a certified baby friendly hospital, were investigated for the 2010, 2013 and 2016 birth cohorts. The study included a total of 4326 babies of which 1514 were born in the year 2010, 1363 in 2013 and 1449 in 2016. Of the 4326 babies included in the study, 3196 (73,8%) were discharged with exclusive breastfeeding (breastfeeding and/or expressed breastmilk), 22% with breastmilk+formula, and 1,25% with formula. Discharge with exclusive breast feeding was more common in the infants of mothers who were between 18-30 years of age. Gestational age less than 37 weeks was associated with a lower exclusive breastfeeding rate at discharge (65,6%). Babies who were born with vaginal delivery were more commonly discharged with exclusive breastfeeding (79,8%) when compared to those born with caesarean section (71,3%). Exclusive breastfeeding rates were also higher in infants with a birth weight between 2500 and 4000 grams and above 4000 grams (60% in infants with a birth weight <2500 grams; 77,3% in those between 2500-4000 grams; and 77% in the infants >4000 grams). Those who were breastfed in the first 30 minutes after birth were 4.04 times (95% CI:1,85-8,82) and those between 31-60 minutes of life were 2,11 times (95% CI:1,54-5,91) more likely to be exclusively breastfed at discharge compared to infants who were breastfed after the first day of life. Infants who were given a pacifier at least for once were 2.76 times more likely to be exclusively breastfed at discharge compared to those who never used a pacifier (95% CI:1,19-6,39) (p=0,018) Exclusive breastfeeding rate was found to be higher in infants who were discharged during the day time compared to those who were discharged at night or weekend shifts (adjusted ORs 2,25, 95% CI 1,82-2,78). Findings of this study may guide the implementation and training activities of the Baby Friendly Hospital program in the coming years in a more effective way. Key Words: Baby friendly hospital, Breast milk, Breastfeeding