Abstract
Background
Current breastfeeding guidelines promote initiating breastfeeding ≤1 h after birth
to establish long-term breastfeeding. Previous studies dichotomized initiation to
≤1 h versus subsequent hours combined. There are limited data evaluating the effect
of initiation in each subsequent hour on breastfeeding duration. Our objective was
to evaluate the association between breastfeeding initiated at ≤1 h versus the subsequent
23 hours after birth and outpatient breastfeeding duration.
Methods
In this retrospective cohort study, we analyzed real-time, discretely documented electronic
health record (EHR) breastfeeding data for 3315 infants born at a university center
and followed to age ≥12 mo at 27 university primary care clinics. The primary outcome
was breastfeeding duration. The exposure variable was hour of breastfeeding initiation
within 24 h postnatally. Data were analyzed by univariable and multivariable linear
regression separately for infants born by vaginal versus cesarean delivery.
Results
In adjusted models, initiating breastfeeding during each hour from age >1 to ≤6 h
and during ages >6 to ≤24 h was not associated with decreased breastfeeding duration
versus initiating breastfeeding at ≤1 h after birth for infants born via vaginal or
cesarean delivery.
Conclusions
Delaying breastfeeding initiation to >1 to ≤24 h after birth is not associated with
decreased breastfeeding duration compared with initiating breastfeeding at ≤1 h after
birth. Integration of breastfeeding measures into inpatient and outpatient EHR discrete
data fields may clarify best practices that support long-term breastfeeding as a public
health imperative.
Keywords
Abbreviations:
CI (confidence interval), EHR (Electronic health record), LASSO (Least absolute shrinkage and selection operator), MICE (Multiple imputation by chained equations)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 18, 2022
Accepted:
July 8,
2022
Received:
January 17,
2022
Footnotes
Conflict of Interest: The authors have indicated that they have no potential conflicts of interests to disclose.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
