Factors Associated with Exclusive Breastfeeding at Hospital Discharge among Native-Born, Immigrant, and Refugee Women

Exclusive breastfeeding is recommended through six months as it supports infant growth and development. Yet, many mothers do not exclusively breastfeed in early postpartum.

To examine factors associated with exclusive breastfeeding at hospital discharge among culturally diverse women.

This cross-sectional study used data of women who gave birth at a major medical center in Israel in 2015-2017. Descriptive statistics and regression analysis were conducted to examine maternal characteristics and associated breastfeeding outcomes by hospital discharge.

Among 10,978 women, 17.8% (n=1958) exclusively breastfed, 57.9% (n=6357) partially breastfed, and 24.3% (n=2663) did not breastfeed. Among Israeli-born and former Soviet Union-born Jewish women, breastfeeding intention (odds ratio [OR] 19.59, 95% confidence interval [95%CI] 10.27-37.35 and OR 15.92, 95%CI 5.79-43.80, respectively) and early breastfeeding (OR 2.415, 95%CI 1.91-3.05 and OR 2.04, 95%CI 1.57-2.64, respectively) were associated with exclusive breastfeeding. The only significant factor associated with exclusive breastfeeding among refugees and Israeli-born Muslim women was early breastfeeding (OR 1.61, 95%CI 1.20-2.16). For Ethiopian-born Jewish women, not married (OR 0.330, 95%CI 0.114-0.955) and cesarean delivery (OR 0.481, 95%CI 0.232-0.998) were negatively associated with exclusive breastfeeding.

Despite having access to the same hospital-based breastfeeding support, there were differences among ethno-culturally diverse women in Israel. In this study, we identified maternal characteristics associated with early breastfeeding among women of diverse ethno-cultural backgrounds. Study findings highlight the importance of ethno-cultural considerations in breastfeeding practices and inform health professionals of factors associated with exclusive breastfeeding in early postpartum.