Exclusive Breastfeeding In China Research Articles

What are the determinants of low exclusive breastfeeding prevalence in China? A cross-sectional study.

Exclusive breastfeeding (EBF) status is far from the national target in China. To identify the modifiable factors associated with EBF of infants aged under 6 months in China. A cross‐sectional study was conducted in 12 provinces/municipalities across China in 2017–2018. We used multistage stratified cluster sampling and collected data through face‐to‐face interviews with mothers using an electronic questionnaire. Totally, 5287 pairs of mother–infant aged <6 months were investigated. The EBF prevalence was 29.2% (1544/5287). Mothers with correct knowledge of colostrum (adjusted odds ratio [AOR]:1.32, 95% confidence interval [CI]: 1.07, 1.62), EBF (AOR: 1.39, 95% CI: 1.06, 1.81) and the highest scores of perceptions for breastfeeding benefits (AOR: 1.36, 95% CI: 1.14, 1.61) were more likely to exclusively breastfeed. However, mothers with more frequent unwillingness of breastfeeding during the first month postpartum were less likely to practice EBF (AOR: 0.68, 95% CI: 0.52, 0.90). Infants having their first breast milk within 24 h of birth increased the odds of EBF (AOR: 2.41, 95% CI: 1.86, 3.13). Infants were less likely to be exclusively breastfed in the families in which the main caregiver was the grandmothers. Mothers without receiving infant formula feeding suggestions via the health facilities, media, or the Internet (AOR: 1.57, 95% CI: 1.33, 1.85) or without the experience of infant formula feeding in public (AOR: 1.45, 95% CI: 1.23, 1.72) might more likely to practice EBF. To acquire comprehensively correct knowledge and keep a positive attitude of breastfeeding for the mothers are crucial for improving the EBF prevalence. Family supports are potential interventions worth focusing on. Infant formula promotion remains a great barrier for EBF in China.

Association of Breastfeeding for the First Six Months of Life and Autism Spectrum Disorders: A National Multi-Center Study in China.

Previous studies have shown that exclusive breastfeeding is associated with lower odds of having autism spectrum disorders (ASD) in children, but data are lacking in Asian countries, especially China. This cross-sectional study of seven cities in China collected data from August 2016 to March 2017 from 6049 toddlers aged 16–30 months and their parents who responded to questionnaires. The breastfeeding status was collected via questionnaires based on recommendations from the World Health Organization. The standard procedure for screening and diagnosis was applied to identify toddlers with ASD. Among the 6049 toddlers (3364 boys [55.6%]; mean [SD] age, 22.7 [4.1] months), 71 toddlers (1.2%) were identified as ASD. The prevalence of exclusive breastfeeding, partial breastfeeding, and not breastfeeding was 48.8%, 42.2%, and 9.1%, respectively. Compared to toddlers with exclusive breastfeeding, toddlers with partial breastfeeding or without breastfeeding had higher odds of having ASD (odd ratios [OR]: 1.55, 95% confidence interval [CI]: 0.90–2.74; OR: 2.34, 95% CI: 1.10–4.82). We did not find significant modification of demographic characteristics on the associations. The results remained robust in multiple sensitivity analyses. Toddlers without breastfeeding for the first six months of life had higher odds of having ASD, and our findings shed light on the necessity of strengthening public health efforts to increase exclusive breastfeeding in China.

Exclusive breastfeeding in rural Western China: does father\u2019s co-residence matter?

BackgroundChina suffers from a low exclusive breastfeeding rate. Though it has been proofed that paternal support benefits breastfeeding a lot, the correlation between father’s co-residence and exclusive breastfeeding in China remain undiscovered. This study is to provide population-based evidence for the association of paternal co-residence on exclusive breastfeeding in rural western China. We also attempt to detect how the process works by examining the correlation between the father’s co-residence and breastfeeding family support as well as maternal decision-making power.MethodsA cross-sectional study was conducted in 13 nationally-designated poverty-stricken counties in the Qinba Mountains area in 2019. Data on breastfeeding practices, the status of fathers co-residence, breastfeeding family support, and maternal decision-making power were collected via structured questionnaires from 452 caregivers-infant pairs. Multivariate regressions were conducted to explore the correlation between paternal co-residence and exclusive breastfeeding.ResultsThe exclusive breastfeeding (0–6 months) rate was 16% in rural western China. Fathers’ co-residence was associated with a lower exclusive breastfeeding rate (OR = 0.413, 95% CI = 0.227–0.750, P = 0.004) and the rate did not improve when the father was the secondary caregiver. Even ruling out support from grandmothers, the association was still negative. Paternal co-residence did not improve maternal perceived breastfeeding family support, neither practically nor emotionally (β =0.109, P = 0.105; β =0.011,P = 0.791, respectively) and it reduced maternal decision-making power (β = − 0.196, P = 0.007).ConclusionsFathers’ co-residence is negatively associated with the exclusive breastfeeding rates in rural western China. More skill-based practical and emotional strategies should be considered on father’s education to help them better involvement and show more respect to mothers’ decisions.

Factors associated with exclusive breastfeeding practice among mothers in nine community health centres in Nanning city, China: a cross-sectional study

BackgroundThe prevalence of exclusive breastfeeding (EBF) is suboptimal in China. There is limited evidence of effective interventions to increase EBF in China. Therefore, it is urgent to explore the potential factors that may be effective in promoting exclusive breastfeeding. Previous studies have mainly focused on socio-demographic factors and the Han ethnic group. This study explores more modifiable influencing factors of EBF in the Guangxi Zhuang Autonomous Region of China.MethodsThe cross-sectional data used in this study were collected to provide baseline information on EBF prevalence for a breastfeeding promotion project. A total of 494 mothers of infants aged 0–5 months were recruited from nine community health centres in Nanning, China, in October 2019. Data were collected through face-to-face interviews using structured questionnaires. Infant feeding was measured by 24-h recall. The Chinese version of the Breastfeeding Self-Efficacy Scale–Short Form was used to examine the maternal breastfeeding self-efficacy. Univariate and multivariate logistic regressions were used to examine the factors associated with EBF practices.ResultsIn the present study, the prevalence of exclusive breastfeeding was 37.0%. Higher breastfeeding self-efficacy scores (adjusted odds ratio [AOR] 1.93; 95% confidence interval [CI] 1.25, 2.98), a college degree or above (AOR 2.15; 95% CI 1.24, 3.71), and early initiation of breastfeeding (AOR 2.06; 95% CI 1.29, 3.29) were positively associated with EBF practice. However, the preparation for infant formula before childbirth (AOR 0.30; 95% CI 0.17, 0.52) and premature birth (AOR 0.30; 95% CI 0.10, 0.87) were negatively associated with EBF practice.ConclusionsExclusive breastfeeding practice was suboptimal and associated with various factors in the study area. The prevalence of EBF was positively associated with higher breastfeeding self-efficacy, education level of mothers, and early initiation of breastfeeding, whereas premature birth and preparation for infant formula before childbirth were barriers to exclusive breastfeeding. Future intervention projects should target mothers with premature babies, lower levels of education, and breastfeeding self-efficacy. Breastfeeding-friendly practices, such as the early initiation of breastfeeding and regulations on breastmilk substitutes, should also be encouraged.

Breastfeeding practice in China from 2013 to 2018: a study from a national dynamic follow-up surveillance

BackgroundBreastfeeding is important for the physical and psychological health of the mother and child. Basic data on breastfeeding practice in China are out-of-date and vary widely. This study aimed to evaluate the progress of breastfeeding practice in China, as well as to explore the bottlenecks in driving better practice.MethodsThis was an observational study. We used data from the Under-5 Child Nutrition and Health Surveillance System in China for the period 2013–2018. The prevalence of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) were calculated for each year for subgroups of China. The Cochran-Armitage test was used to explore the time trends. The annual percent of change (APC) were calculated by log-linear regression followed by exp transformation.ResultsThe prevalence of EIBF increased significantly from 44.57% (95% CI: 44.07, 45.07) in 2013 to 55.84% (95% CI: 55.29, 56.38) in 2018 (Ptrend < 0.001), with an APC of 4.67% (95% CI: 3.51, 5.85). And the prevalence of EBF increased rapidly from 16.14% (95% CI: 15.10, 17.18) to 34.90% (95% CI: 33.54, 36.26) (Ptrend < 0.001), with an APC of 14.90% (95% CI: 9.97, 20.04). Increases were observed in both urban and rural areas, with urban areas showing greater APCs for EIBF (6.05%; 95% CI: 4.22, 7.92 v.s. 2.26%; 95% CI: 1.40, 3.12) and EBF (18.21%; 95% CI: 11.53, 25.29 v.s. 9.43%; 95% CI: 5.52, 13.49). The highest EBF prevalence was observed in the East, but the Central area showed the highest APC. The prevalence of EBF decreased with increasing age within the first 6 months, especially after 3 months.ConclusionThe prevalence of both EIBF and EBF in China are improving in recent years. The rural and West China could be the key areas in the future actions. More efforts should be made to protect and promote breastfeeding to achieve near- and long-term goals for child health.

WeChat-based intervention to support breastfeeding for Chinese mothers: protocol of a randomised controlled trial

BackgroundExclusive breastfeeding for the first 6 months of life is the optimal way to feed infants. However, recent studies suggest that exclusive breastfeeding rates in China remain low and are well below the recommended target. There has been evidence that a lack of awareness of, or exposure to, breastfeeding information is associated with poor breastfeeding practices. WeChat, the most widely used social networking platform in China, has shown some potential to promote health behaviours. We thus hypothesised that a breastfeeding intervention program delivered via WeChat would achieve at least a 10% increase in exclusive breastfeeding prevalence at 6 months compared to the control group.MethodsA two-arm, parallel, multicentre randomised controlled trial of 1000 pregnant women will be conducted at four maternity hospitals of Chengdu, China. Eligible women who consent to participate in the trial will be recruited at 28–30 weeks of gestation, and randomly allocated to either the intervention group (participants receive breastfeeding-related information from WeChat) or the control group (participants receive non-breastfeeding information from WeChat) using a central randomisation system on a 1:1 ratio at each participating site. The primary outcomes are exclusive breastfeeding rate and full breastfeeding rate at 6 months postpartum. All randomised participants will be included in the outcome analyses with missing data being imputed based on the best-case and worst-case scenarios. Multilevel mixed regression models will be used in the primary analyses to assess the effectiveness of intervention program on the breastfeeding rates.DiscussionThis trial uses the most widely used social media program as a means of delivering messages to mothers to increase exclusive breastfeeding in China. Increasing exclusive breastfeeding will contribute to meeting the health and environmental goals of the Sustainable Development Guidelines.Trial registration ClinicalTrials.gov, NCT04499404. Registered 5 August 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04499404

Effects of baby-friendly practices on breastfeeding duration in China: a case-control study

BackgroundThe Baby-Friendly Hospital Initiative is generally considered an effective way to promote breastfeeding. Although China has the largest number of baby-friendly hospitals in the world, research on baby-friendly practices in China is limited, and the rate of exclusive breastfeeding (EBF) at 6 months, 20.7%, compared to the 2025 global goal of 50% is low. It is, therefore, important to determine the factors that remain significant barriers to EBF in China. To explore how the key baby-friendly practices affect EBF duration in China, we used a case-control study to compare the effects of baby-friendly-related practices on both EBF and non-breastfeeding (NBF) mothers at 3 months and to investigate the effects of both single and comprehensive baby-friendly practices in promoting EBF duration at 3 months, which is one step toward EBF at 6 months.MethodsParticipants were recruited from four maternal and child health hospitals in western (Chongqing), eastern (Qingdao), southern (Liuzhou), and central China (Maanshan). A total of 421 mothers (245 in the EBF group, 176 in the NBF group) of infants aged 3 months were surveyed through a self-reported questionnaire from April 2018 to March 2019. The experience of baby-friendly practices and breastfeeding during hospitalization were assessed with yes/no questions. Socio-demographic factors that influenced breastfeeding at 3 months were analyzed using bivariate and multivariate logistic regression analyses.ResultsOf mothers in the EBF group, 65.57% reported engaging in at least seven baby-friendly practices compared to 47.72% of mothers in the NBF group. Significantly more mothers in the EBF group engaged in baby-friendly practices than in the NBF group. These practices included “breastfeeding within one hour after birth” (74.29% vs. 59.09%), “breastfeeding on demand” (86.48% vs. 75.00%), and “never use a pacifier” (46.53% vs. 31.25%). After adjusting for confounding variables, we found that the mothers who engaged in fewer than seven baby-friendly practices were about 1.7 times less likely to breastfeed than were those who engaged in seven or more baby-friendly practices (odds ratio [OR] 1.720, 95% confidence interval [CI] 1.106, 2.667). Further, the mothers who did not breastfeed on demand were as likely to not breastfeed up to 3 months (OR 2.263, 95% CI 1.265, 4.049), as were mothers who did not breastfeed during hospitalization (OR 4.379, 95% CI 1.815, 10.563).ConclusionsThese data from hospitals in China suggest that higher compliance with baby-friendly practices may have a positive impact on EBF at 3 months, particularly in terms of promoting the implementation of breastfeeding on demand and breastfeeding during hospitalization in China.

The effectiveness of using a WeChat account to improve exclusive breastfeeding in Huzhu County Qinghai Province, China: protocol for a randomized control trial

BackgroundAn exclusive breastfeeding rate in the first 6 months of life of at least 50% is one of the six World Health Organization global nutrition targets for 2025. However, the exclusive breastfeeding rate in China is quite low and decreasing which makes it urgent to explore effective ways to reverse the current downward trend. As mobile technologies have rapidly developed, mobile communication apps such as WeChat (one of the largest social networking platforms in China) are well accepted and have the potential to improve health behaviors in a convenient way. The current paper describes the study protocol of a WeChat intervention that aims to promote breastfeeding in rural areas in China.MethodsThe study is designed as a randomized controlled trial in rural Qinghai Province, China. Women who are 14–36 weeks pregnant will be randomized to routine antenatal and postnatal care, or routine care plus the WeChat breastfeeding education. pregnant women with a severe disease and complications of pregnancy or HIV-1 will be excluded. Breastfeeding knowledge and promotion information will be delivered to the intervention group through a WeChat official account from 3 months pregnancy to 6 months postpartum. The outcome assessments are conducted at baseline through face-to-face interviews, and at one week, 1 month, 3 months and 6 months postpartum by telephone interviews. The primary outcome is difference in the exclusive breastfeeding rate at 1 month, 3 months, and 6 months postpartum between the intervention group and the control group. Secondary outcomes include the overall duration of any and exclusive breastfeeding across the first 6 months postpartum; mothers’ knowledge of breastfeeding; the proportion of early initiation of breastfeeding; and the timing of the introduction of solid food to infants. Intention-to-treat-analysis will be used. Survival analysis will be used to compare the overall duration of any and exclusive breastfeeding between groups.DiscussionThis study is the first effort to promote exclusive breastfeeding through WeChat in China. Our results will provide scientific evidence for the effect of health education through WeChat on breastfeeding. Thereby this may offer a comprehensive intervention to promote exclusive breastfeeding in China and other settings.Trial registrationChinese Clinical Trial Registry –ChiCTR1800017364. Registered 26 July 2018. http://www.chictr.org.cn/showproj.aspx?proj=29325

China should take more measures to raise its breastfeeding rate.

A growing number of studies show that breastfeeding is the best source of nutrition for infants and young children and one of the most effective measures to ensure the healthy growth and development of children. However, a study from the China Development Research Fund found that the rate of exclusive breastfeeding among Chinese infants within six months of birth is only 29%, a rate that is lower than that in other countries and regions of the world. Other data provided by the World Bank shows that the rate of exclusive breastfeeding in China declined from 1998 to 2013 and that it increased slightly by 2018, but it was still lower than the global average. Compared to other Asian countries, the exclusive breastfeeding rate in China is also low. Establishing a sound breastfeeding support system and creating a breastfeeding environment with full support for mothers of infants is a way to effectively improve the state of breastfeeding in China, to ensure the healthy growth of children, and to achieve the goals of Healthy China 2030.

Family-Centered Breastfeeding Education to Promote Primiparas' Exclusive Breastfeeding in China.

Few breastfeeding education programs focus on primiparas and the importance of family members on exclusive breastfeeding in China. Research aim: This study aimed to explore the influence of a family-centered breastfeeding education program in promoting exclusive breastfeeding up to 6 months postpartum and to improve women's attitude and knowledge, family members' knowledge, and family support. This was a two-group quasi-experimental design with multiple comparisons. Participants ( N = 59) were randomized to either the intervention ( n = 29) or the control ( n = 30) group. The intervention group received two prenatal breastfeeding education lectures that included important family members, three home visits, eight telephone calls, text or video/audio support, and quality online resources during lactation. The control group received in-hospital care and follow-up by community nurses after discharge. Compared with the control group, the intervention group was more likely to exclusively breastfeed in the first 6 months, odds ratio = 0.44, 95% confidence interval [0.20, 0.98]. The mean knowledge level of the intervention group improved more across time ( p < .05) and was higher than the control group ( p < .05). Perceived family support within the intervention group was significantly higher than the control group from 1 to 6 months ( p < .05). The breastfeeding education program is an effective strategy to promote exclusive breastfeeding in China.

Effectiveness of a theory-based breastfeeding promotion intervention on exclusive breastfeeding in China: A randomised controlled trial

ObjectiveTo investigate the effectiveness of a designed intervention programme on the promotion of exclusive breast feeding during 6 months post partum among Chinese primiparous women, based on the theory of planned behaviour. DesignRandomised controlled trial. SettingA tertiary hospital in Shanghai, China. ParticipantsChinese primiparous women who were able to breastfed their babies and companied by either husband or mothers. InterventionParticipants were randomly divided into the intervention and control group. On the basis of the theory of planned behaviour, mothers in the intervention group received the TPB-based intervention programme, including individual instruction, group education and telephone counselling, whereas both the intervention and control group continued to receive routine nursing care. Measurements and FindingsData were collected between October 2013 and June 2014. Initially, 352 participants were included. However, 67 of them dropped out or were lost to follow-up. Finally, 285 participants were included into the analysis, including 157 participants in the intervention group and 128 participants in the control group. Though some bias might exist, rates of exclusive breast feeding were consistently and significantly higher in the intervention group than the control group at 3 days (40.1% versus 10.9%, P<0.001), 6 weeks (57.3% versus 29.7%, P<0.001), 4 months (56.7% versus 15.6%, P<0.001) and 6 months post partum (42.0% versus 10.2%, P<0.001). Conclusion and implicationsThe TPB-based breast-feeding promotion intervention is effective in improving exclusive breast-feeding rates in primiparous women. Although the current intervention that provides continued support during the hospitalisation and follow-up at home, problems remains in the workplaces.

A survey on difficulties and desires of breast-feeding women in Wuhan, China

Objectivesexclusive breast feeding in China is relatively low and no research has been conducted to explore the difficulties and desires of Chinese lactating mothers. Currently, Chinese women turn to massage therapists to increase breastmilk volume, implying that many breast-feeding women faced problems but had few support mechanisms.This study aimed to explore the difficulties and desires of Chinese breast-feeding women and to propose strategies for increasing the rate of exclusive breast feeding. Methodsthree hundred and seventy-five primiparous women were recruited from two randomized cluster communities in Wuhan following ethical approval. Face-to-face semistructured interviews were conducted with 76 of the participants to collect data on their infants' feeding status, duration of exclusive breast feeding, reasons for stopping, difficulties encountered, and sources of support for lactation. Resultsthe breast feeding initiation rate was 93.6%, but exclusive breast feeding was only 6.2% at six months. The most frequently cited reason for giving up exclusive breast feeding was perceived breastmilk insufficiency. Women cited a desire for professional and individualised instruction from following resources: (1) lactation consultants in hospital and communities; (2) Qualified cuirushi; (3) breast feeding website;(4) Relatives, friends and peers;(5) Telephone hotline. Conclusionsto improve the rate and duration of exclusive breast feeding in China, effective and available resources must be available. Timely,professional and face-to-face lactation counselling such as lactation consultant, qualified cuirushin is needed.

Effects of a Theory-based Breastfeeding Promotion Intervention on Exclusive Breastfeeding in China

The benefits of exclusive breastfeeding (EBF) are well known; EBF is recommended for the first six months of an infant's life. However, EBF rates remain low and unsatisfactory in China. This study aimed to investigate the effectiveness of a breastfeeding promotion intervention based on the theory of planned behavior (TPB) to promote long-term exclusive breastfeeding rates among first-time Chinese mothers. A longitudinal, randomized, controlled trial was conducted at Shanghai First Maternity and Infant Hospital in Shanghai, China. The participants were 285 first-time Chinese mothers. The intervention group (n=157) was offered a specially designed nursing intervention program based on TPB, whereas the control group (n=128) received routine nursing care. Data of exclusive breastfeeding practices were collected at 3 days, 6 weeks, and 4 and 6 months postpartum. Data pertaining to breastfeeding medi- ating factors were collected three times at the first day after birth, 3 days, and 6 weeks postpartum. A Chi-square test and repeated measures ANOVA were used for the data analysis. The results showed that the intervention group had significantly higher scores than the control group in breastfeeding knowledge, attitude, subjective norm, and perceived control (at least p< 0.01). The rates of exclusive breastfeeding at the different time points of the intervention group (40.1%, 57.3%, 56.7%, and 42.0%) were consistently and significantly higher than those of the control group (10.9%, 29.7%, 15.6%, and 10.2%) (at least p< 0.01). It could be concluded that this theory-based breastfeeding promotion intervention was effective for improving long-term exclusive breastfeeding rates in China.

Predictors of Breastfeeding Exclusivity in Three Cities of China

Breastfeeding MedicineVol. 9, No. 2 Letters to the EditorPredictors of Breastfeeding Exclusivity in Three Cities of ChinaXiu Zhu, Jing Tian, GuiLiu Chen, and Kyllike ChristenssonXiu ZhuPeking University School of Nursing, Beijing, People's Republic of China.Search for more papers by this author, Jing TianThe First Affiliated Hospital with Nanjing Medical University, Nanjing, People's Republic of China.Search for more papers by this author, GuiLiu ChenAn Hui Provincial Hospital, HeFei City, People's Republic of China.Search for more papers by this author, and Kyllike ChristenssonDivision of Reproductive Health, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.Search for more papers by this authorPublished Online:24 Feb 2014https://doi.org/10.1089/bfm.2013.0053AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Predictors of Breastfeeding Exclusivity in Three Cities of China." Breastfeeding Medicine, 9(2), pp. 103–104FiguresReferencesRelatedDetailsCited byMixed milk feeding: a systematic review and meta-analysis of its prevalence and drivers1 May 2020 | Nutrition Reviews, Vol. 78, No. 11Does Caesarean Section Affect Breastfeeding Practices in China? A Systematic Review and Meta-Analysis10 October 2017 | Maternal and Child Health Journal, Vol. 21, No. 11In-Hospital Formula Supplementation of Healthy Newborns: Practices, Reasons, and Their Medical Justification Marija Boban and Irena Zakarija-Grković1 November 2016 | Breastfeeding Medicine, Vol. 11, No. 9Effectiveness of a theory-based breastfeeding promotion intervention on exclusive breastfeeding in China: A randomised controlled trialMidwifery, Vol. 42Predictors of suboptimal breastfeeding: an opportunity for public health interventions4 November 2015 | The European Journal of Public Health, Vol. 26, No. 2 Volume 9Issue 2Mar 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Xiu Zhu, Jing Tian, GuiLiu Chen, and Kyllike Christensson.Predictors of Breastfeeding Exclusivity in Three Cities of China.Breastfeeding Medicine.Mar 2014.103-104.http://doi.org/10.1089/bfm.2013.0053Published in Volume: 9 Issue 2: February 24, 2014Online Ahead of Print:November 26, 2013PDF download

Initiation of breastfeeding and prevalence of exclusive breastfeeding at hospital discharge in urban, suburban and rural areas of Zhejiang China.

BackgroundRates of exclusive breastfeeding in China are relatively low and below national targets. The aim of this study was to document the factors that influence exclusive breastfeeding initiation in Zhejiang, PR China.MethodsA cohort study of infant feeding practices was undertaken in Zhejiang Province, an eastern coastal region of China. A total of 1520 mothers who delivered in four hospitals located in city, suburb and rural areas during late 2004 to 2005 were enrolled in the study. Multivariate logistic regression analysis was used to explore factors related to exclusive breastfeeding initiation.ResultsOn discharge from hospital, 50.3% of the mothers were exclusively breastfeeding their infants out of 96.9% of the mothers who had earlier initiated breastfeeding. Exclusive breastfeeding was positively related to vaginal birth, baby's first feed being breast milk, mother living in the suburbs or rural areas, younger age of mother, lower maternal education level and family income.ConclusionThe exclusive breastfeeding rate in Zhejiang is only 50.3% on discharge and does not reach Chinese or international targets. A number of behaviours have been identified in the study that could be potentially incorporated into health promotion activities.