Nationwide daily exclusive breastfeeding rates during birth hospitalization in Japan
Tsuyoshi Isojima1, Noriko Kato2, Naho Morisaki3
1Department of Pediatrics, Toranomon Hospital, Minato-ku, Japan.
Objective:
Breast milk provides optimal nutrition for infants, with exclusive breastfeeding recommended for the first 6 months of life. Education during birth hospitalization is vital to promote exclusive breastfeeding. However, standardized references for neonatal weight loss rates based on data including national representative, multi-hospital, with different policies remain unavailable.
Methods:
Data of 4774 participants from 146 hospitals throughout Japan were obtained from the national growth survey. Among them, 3302 were eligible for the analysis. Daily exclusive breastfeeding rates and their associations with facility and individual characteristics during birth hospitalization were then analyzed. Additionally, weight loss percentile reference curves by delivery mode were established using the Lambda-Mu-Sigma method.
Results:
The rate was 60.8% on day 0 and plateaued at approximately 25% on day 3. Being born in a facility with high exclusive breastfeeding rate (odds ratio [OR]: 333.3, 95% confidence interval [CI]: 15.2-7142, p < 0.0001), multiparity (OR: 1.9, 95% CI: 1.4-2.5, p < 0.0001), vaginal delivery (OR: 2.2, 95% CI: 1.6-3.1, p < 0.0001), and lower weight loss rate on day 3 (OR: 1.2, 95% CI: 1.1-1.2, p < 0.0001) were identified as independent factors, and facility-level differences accounted for 58.4% of the total variability for exclusive breastfeeding at discharge. Using the data from 831 neonates with exclusive breastfeeding at discharge, weight loss rate references were established.
Conclusion:
This study revealed Japan's nationwide daily exclusive breastfeeding rates during birth hospitalization and their significant influencing factors. The established references may be useful in promoting exclusive breastfeeding clinically.
