O47 - What modifiable factors improve breastfeeding exclusivity and duration in Australian women?

Abstract

Australian breastfeeding rates, particularly exclusive breastfeeding rates, are low and have been low for many years because strategies to increase them have been inadequate. New approaches for promoting and supporting breastfeeding are required. Data collected in 2008 suggested that Australian Breastfeeding Association (ABA) members had much higher exclusive breastfeeding rates (41.2% at 5 to 6 months) than the general Australian population. The Engaging Mothers: Breastfeeding Experiences Recounted (EMBER) project was undertaken 1) to determine whether ABA volunteer trainees had better breastfeeding outcomes and were, in fact, positive deviants regarding breastfeeding practices, 2) to explore attitudes, characteristics and behaviours underpinning beneficial breastfeeding practices and 3) to identify modifiable characteristics to inform breastfeeding promotion and support. Breastfeeding-related quantitative and qualitative data were obtained from lactation history questionnaires collected on application to train as volunteers with ABA and analysed using descriptive statistics. Participants in this project had much higher levels of exclusive breastfeeding to around 6 months (64%) and longer duration of breastfeeding (80% to one year) than the general Australian population, going beyond World Health Organization targets. Modifiable factors that positively influenced breastfeeding outcomes included knowledge of and motivation to breastfeed, birthing outcomes, immediate skin-to-skin contact, lack of in-hospital formula supplementation and partner and peer support. EMBER participants can be defined as positive deviants with positive attitudes, characteristics and behaviours towards breastfeeding that lead to much better breastfeeding outcomes compared to the general Australian population. Many of the modifiable factors that positively impacted their breastfeeding outcomes can be influenced by midwives supporting pregnant women, women giving birth and breastfeeding mothers. Midwives are uniquely positioned to provide breastfeeding education and information, and timely and well-informed breastfeeding support to mothers, to give them the best chance to breastfeed exclusively and breastfeed for longer.