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Impact of mother-baby friendly hospital initiative in a tertiary hospital on success of breastfeeding: A prospective cohort study

Polla Lorence K. Holgado, MD and Wilhelmina A. Mercado, MD, MHA, FPOGS
Department of Obstetrics and Gynecology, University of Santo Tomas Hospital

Objective: To determine the impact of Mother-Baby Friendly Hospital Initiative (MBFHI) implementation on the success of breastfeeding practices among patients who gave birth in a tertiary hospital.

Methodology: Seventy-one postpartum patients who have no contraindications to breastfeeding were recruited from September-November 2017. Outcome variables regarding on the success of breastfeeding initiation on the first hour postpartum and hospital stay were measured. Participants were followed-up by phone call at 3 and 6-months postpartum to determine their practice on exclusive breastfeeding.

Results: The exclusive breastfeeding (EBF) rates at first hour postpartum, during hospital stay, 3 and 6 months were 91.5%, 81.7%, 65.9%, and 45.5%, respectively. The participants who had cesarean delivery and vaginal delivery were 19 (26.8%) and 52 (73.2%) respectively. There was no significant association between the route of delivery and successful breastfeeding at first hour (p = 0.179). At first hour postpartum, majority of the infants who did not initiate breastfeeding was due to respiratory distress. At 6 months, only 39% (26 out of 66) did proper breastfeeding. There were 26 out of 66 (39%) subjects who have work at 6 months, and among these, 12 subjects were not able to collect and store milk due to unavailability of lactation clinic at their workplace. Overall, approximately half of the subjects who initiated EBF were not able to continue EBF until 6 months due to inadequate milk production and resumption of work.

Conclusion: Half of mothers exclusively breastfed up to 6 months, regardless of age, parity and route of delivery. The main determinants of EBF cessation at 6-month postpartum include inadequate milk production, resumption of work and inability to collect milk. To promote successful EBF among mothers in the Philippines, interventions should focus on strengthening the breastfeeding policy implementation in the workplace and communities to promote, protect and maintain breastfeeding.