Abstract
BackgroundThe World Health Organization recommends exclusive breastfeeding for six months, defined as no other solids or liquids besides breast milk and essential vitamins or medicines. Data about exclusive breastfeeding are limited in Georgia, and the information that exist are provided by national surveys, that present inconsistent numbers. Georgia has recently established a national birth registry, which includes information about early postpartum breastfeeding. The objective of this study was to identify factors associated with exclusive breastfeeding of term newborns at hospital discharge in Georgia, using national registry data.MethodsAll live, singleton, term births registered in the Georgian Birth Registry in November and December 2017 were included, with a final study sample of 7134 newborns. Newborns exclusively breastfed at hospital discharge were compared with those who were not, and potential factors were assessed with logistic regression analysis. Hospital discharge normally occurred between 2 and 5 days postpartum.ResultsThe study identified several factors associated with nonexclusive breastfeeding of term newborns at hospital discharge in Georgia: maternal higher education compared to secondary education or less (Adjusted Odds Ratio [AOR] 0.75; 95% CI 0.59, 0.97), caesarean delivery compared to vaginal or assisted vaginal delivery (AOR 0.47; 95% CI 0.37, 0.60), birthweight < 2500 g compared to 3000–3499 g (AOR 0.51; 95% CI 0.27, 0.97), and admission to neonatal intensive care unit after delivery (AOR 0.02; 95% CI 0.02, 0.03). None of the following factors were associated with exclusive breastfeeding at discharge: mother’s age, marital status, Body Mass Index (BMI), parity, in vitro fertilization, maternal intrapartum complications and the sex of the newborn.ConclusionsTo the authors’ knowledge, this is the first time determinants of exclusive breastfeeding at hospital discharge have been studied in Georgia. Several factors associated with nonexclusive breastfeeding at discharge were identified, most noteworthy were caesarean delivery and admission to neonatal intensive care unit. These findings are of importance to the Georgian health authorities and maternal/child non-governmental organizations.
Highlights
The World Health Organization recommends exclusive breastfeeding for six months, defined as no other solids or liquids besides breast milk and essential vitamins or medicines
Newborns born by caesarean delivery were 53% less likely to be exclusively breastfed at hospital discharge compared to those born by vaginal delivery (AOR 0.47; 95% confidence intervals (CI) 0.37, 0.60)
Newborns admitted to neonatal intensive care unit (NICU) were 98% less likely to be exclusively breastfed at hospital discharge compared to newborns who were not admitted (AOR 0.02; 95% CI 0.02, 0.03)
Summary
The World Health Organization recommends exclusive breastfeeding for six months, defined as no other solids or liquids besides breast milk and essential vitamins or medicines. The objective of this study was to identify factors associated with exclusive breastfeeding of term newborns at hospital discharge in Georgia, using national registry data. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of a child’s life, defined as no other solids or liquids besides breast milk and essential vitamins or medicines, and continued breastfeeding up to the age of two years or beyond [1]. In low- and middleincome countries, only 37% of children under the age of six months are exclusively breastfed [3], despite the fact that breastfeeding is associated with numerous shortand long-term health advantages for both the mother and child. In addition to maternal and/ or newborn distress, the effect of caesarean delivery on early breastfeeding might be related to delayed onset of lactation, problems with newborn suckling, disrupted early skin-to-skin contact and mother-newborn interaction, and postoperative hospital practices [23]
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