Breastfeeding promotion in non‐UNICEF‐certified hospitals and long‐term breastfeeding success in Germany

Abstract

Aim: To assess breastfeeding practices using the World Health Organization/United Nations Children's Fund (WHO/UNICEF) Ten Steps to Successful Breastfeeding for Baby‐Friendly Hospitals in unselected non‐UNICEF certified German hospitals and to examine the influences of breastfeeding promotion on long‐term breastfeeding success as assessed by WHO criteria. Methods: Information on the fulfilment of the Ten Steps was collected in 177 randomly chosen maternity hospitals by a postal questionnaire. Breastfeeding duration was assessed in 1487 mothers delivering in these hospitals. Multiple logistic regression was used to estimate the association between a low breastfeeding promotion index, defined as fulfilment of fewer than five steps, and the risk of short‐term breastfeeding, less than 4 mo. Results: A higher breastfeeding promotion index was not associated with early breastfeeding but was significantly associated with full breastfeeding at 4 and 6 mo. After adjusting for confounding factors, delivering in a hospital with a low breastfeeding promotion index was associated with an increased risk of short‐term breastfeeding [odds ratio (OR) 1.24], although associations with maternal demographic variables (young age: OR 3.34), low educational level (OR 2.81) and upbringing in East Germany (OR 2.27) were stronger. Conclusion: In unselected German hospitals even moderate levels of breastfeeding promotion identified by WHO/UNICEF criteria were associated with long‐term breastfeeding success.