Background
‘Infant feeding at hospital discharge’ New South Wales Australia
Methods
Study design
Survey development and questions
Setting and recruitment
Statistical analysis
Results
Participant characteristics and discharge practice
Characteristic | Regional | Sydney Metro | ||
---|---|---|---|---|
n (%) | n (%) | Total | ||
Age (n = 319) | < 30 yrs. | 19 (12) | 25 (15) | 44 |
30–40 yrs. | 32 (21) | 57 (35) | 89 | |
41–50 yrs. | 43 (28) | 34 (21) | 77 | |
> 50 yrs. | 61 (39) | 48 (29) | 109 | |
First professional | Australia | 148 (95) | 149 (91) | 297 |
Registration (n = 297) | United Kingdom | 3 (2) | 7 (4) | 10 |
Other | 4 (3) | 8 (5) | 12 | |
Highest qualification | Current student | 2 (1) | 5 (3) | 7 |
(n = 168) | Certificate | 9 (6) | 21 (13) | 30 |
Grad Dip/Certificate | 16 (10) | 12 (7) | 28 | |
Diploma | 19 (12) | 17 (10) | 36 | |
Bachelor | 80 (52) | 88 (54) | 168 | |
Masters | 27 (17) | 20 (12) | 47 | |
Other | 1 (1) | 1 | ||
PhD | 1 (1) | 1 (1) | 2 | |
Main area of work | Lactation Consultant | 2 (1) | 2 | |
Continuity of care model | 18 (12) | 8 (5) | 26 | |
Antenatal Clinic | 7 (5) | 3 (2) | 10 | |
Birth unit | 10 (6) | 15 (9) | 25 | |
Postnatal ward | 24 (15) | 46 (28) | 70 | |
NICU/SCN | 9 (6) | 18 (11) | 27 | |
Rotational midwife | 61 (39) | 36 (22) | 97 | |
Midwifery in the home | 4 (3) | 13 (8) | 17 | |
Student midwife/nurse | 2 (1) | 4 (2) | 6 | |
Other | 20 (13) | 19 (12) | 39 | |
Clinical role | Clinical midwifery consultant | 14 (9) | 14 (9) | 28 |
Clinical midwifery specialist | 4 (3) | 1 (1) | 5 | |
Midwife educator | 12 (8) | 7 (4) | 19 | |
Midwife | 100 (65) | 104 (63) | 204 | |
Manager | 6 (4) | 5 (3) | 11 | |
Nurse | 4 (3) | 14 (9) | 18 | |
Nurse educator | 2 (1) | 4 (2) | 6 | |
Other | 11 (7) | 8 (5) | 19 | |
Student nurse/midwife | 2 (1) | 7 (4) | 9 | |
Years practiced | < 5 | 63 (41) | 71 (43) | 134 |
5–9 | 30 (19) | 38 (23) | 68 | |
≥ 10 | 62 (40) | 55 (34) | 117 | |
Provides breastfeeding support (n = 319) | No | 9 (6) | 8 (5) | 17 |
Yes | 146 (94) | 156 (95) | 302 | |
Years providing breastfeeding support | < 5 | 41 (28) | 54 (35) | 95 |
5–9 | 29 (20) | 38 (24) | 67 | |
≥ 10 | 76 (52) | 64 (41) | 140 | |
IBCLC | No | 118 (76) | 120 (73) | 238 |
Previously but not re-certified | 12 (8) | 6 (4) | 18 | |
Working towards | 6 (4) | 14 (9) | 20 | |
Yes- currently certified | 19 (12) | 24 (15) | 43 |
Reference timeframe currently used by participants to define ‘infant feeding at hospital discharge’
Local Health District | Total | Most recent single feeding episode | Most recent two or three feeding episodes | Feeding over the previous 12 h | Feeding over the previous 24 h | All feeding since birth | Other |
---|---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | ||
Sydney | 8 | 1 (13) | 4 (50) | 3 (38) | |||
South-Eastern Sydney | 26 | 3 (12) | 3 (12) | 7 (27) | 10 (38) | 3 (12) | |
South-Western Sydney | 25 | 1 (4) | 1 (4) | 10 (40) | 12 (48) | 1 (4) | |
Western Sydney | 73 | 1 (1) | 12 (16) | 5 (7) | 25 (34) | 26 (36) | 4 (5) |
Northern Sydney | 16 | 1 (6) | 1 (6) | 4 (25) | 2 (13) | 7 (44) | 1 (6) |
Nepean Blue Mountains | 16 | 1 (6) | 2 (13) | 7 (44) | 5 (31) | 1 (6) | |
Illawarra Shoalhaven | 32 | 1 (3) | 5 (16) | 1 (3) | 12 (38) | 11 (34) | 2 (6) |
Murrumbidgee | 26 | 1 (4) | 10 (38) | 12 (46) | 3 (12) | ||
Central Coast | 22 | 3 (14) | 4 (18) | 6 (27) | 9 (41) | ||
Hunter New England | 25 | 1 (4) | 4 (16) | 1 (4) | 10 (40) | 8 (32) | 1 (4) |
Mid North Coast | 3 | 3 (100) | |||||
Northern NSW | 10 | 2 (20) | 1 (10) | 4 (40) | 3 (30) | ||
Southern NSW | 16 | 1 (6) | 2 (13) | 5 (31) | 6 (38) | 2 (13) | |
Western NSW | 18 | 1 (6) | 2 (11) | 3 (17) | 10 (56) | 2 (11) | |
Far West | 3 | 1 (33) | 1 (33) | 1 (33) | |||
Total | 319 | 6 (2) | 35 (11) | 27 (8) | 105 (33) | 126 (39) | 20 (6) |
Participants recommendations for a reference timeframe to define ‘infant feeding at hospital discharge’
Local Health District | Total | Most recent single feeding episode | Most recent two or three feeding episodes | Feeding over the previous 12 h | Feeding over the previous 24 h | All feeding since birth |
---|---|---|---|---|---|---|
n | n (%) | n (%) | n (%) | n (%) | n (%) | |
Sydney | 8 | 7 (88) | 1 (13) | |||
South-Eastern Sydney | 26 | 1 (4) | 3 (12) | 4 (15) | 14 (54) | 4 (15) |
South-Western Sydney | 24 | 3 (12) | 16 (64) | 5 (20) | ||
Western Sydney | 73 | 1 (1) | 11 (15) | 6 (8) | 45 (62) | 10 (14) |
Northern Sydney | 15 | 1 (6) | 1 (6) | 3 (19) | 8 (50) | 2 (13) |
Nepean Blue Mountains | 15 | 2 (13) | 1 (6) | 3 (19) | 6 (38) | 3 (19) |
Illawarra Shoalhaven | 31 | 2 (6) | 2 (6) | 1 (3) | 20 (63) | 6 (19) |
Murrumbidgee | 26 | 3 (12) | 17 (65) | 6 (23) | ||
Central Coast | 22 | 4 (18) | 6 (27) | 8 (36) | 4 (18) | |
Hunter New England | 25 | 1 (4) | 4 (16) | 2 (8) | 13 (52) | 5 (20) |
Mid North Coast | 3 | 1 (33) | 2 (67) | |||
Northern NSW | 10 | 2 (20) | 1 (10) | 6 (60) | 1 (10) | |
Southern NSW | 16 | 1 (6) | 4 (25) | 10 (63) | 1 (6) | |
Western NSW | 18 | 1 (6) | 2 (11) | 13 (72) | 2 (11) | |
Far West | 3 | 1 (33) | 2 (67) | |||
Total | 315 | 9 (3) | 34 (11) | 35 (11) | 187 (59) | 50 (16) |
Timeframe reference | Current reference n (%) Total = 319 | Recommended reference n (%) Total = 315 |
---|---|---|
≤ 24 h grouping | ||
Most recent feed | 6 (2) | 9 (3) |
Most recent 2–3 feed | 35 (11) | 34 (11) |
≤ 12 h | 27 (8) | 35 (11) |
≤ 24 h | 105 (33) | 187 (59) |
All feeds since birth | 126 (39) | 50 (16) |
Other | 20 (6) | - |
Reference timeframe currently used by participants to define ‘full breastfeeding’ at hospital discharge
Local Health District | Total | Mothers’ intention at discharge | On the day of discharge | Over the last 12 h | Over the previous 24 h | Since birth | Question not answered |
---|---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | ||
Sydney | 8 | 1 (13) | 5 (63) | 1 (13) | 1 (13) | ||
South-Eastern Sydney | 26 | 1 (4) | 8 (31) | 3 (12) | 4 (15) | 8 (31) | 2 (7) |
South-Western Sydney | 25 | 9 (36) | 1 (4) | 5 (20) | 8 (32) | 2 (8) | |
Western Sydney | 73 | 6 (8) | 17 (23) | 8 (11) | 21 (29) | 20 (27) | 1 (2) |
Northern Sydney | 16 | 5 (31) | 1 (6) | 5 (31) | 5 (31) | ||
Nepean Blue Mountains | 16 | 4 (25) | 1 (6) | 4 (25) | 4 (25) | 3 (19) | |
Illawarra Shoalhaven | 32 | 2 (6) | 7 (22) | 2 (6) | 10 (31) | 8 (25) | 3 (10) |
Murrumbidgee | 26 | 3 (12) | 1 (4) | 11 (42) | 11 (42) | ||
Central Coast | 22 | 1 (5) | 9 (41) | 1 (5) | 5 (23) | 6 (27) | |
Hunter New England | 25 | 5 (20) | 3 (12) | 10 (40) | 7 (28) | ||
Mid North Coast | 3 | 2 (67) | 1 (33) | ||||
Northern NSW | 10 | 3 (30) | 1 (10) | 3 (30) | 3 (30) | ||
Southern NSW | 16 | 10 (63) | 3 (19) | 3 (19) | |||
Western NSW | 18 | 8 (44) | 1 (6) | 4 (22) | 5 (28) | ||
Far West | 3 | 1 (33) | 1 (33) | 1 (33) | |||
TOTAL | 319 | 10 (3) | 90 (28) | 23 (7) | 93 (29) | 91 (29) | 12 (4) |
Exclusive breastfeeding as a category definition to report
Free text additional comments on ‘infant feeding at hospital discharge’
“Clear definition is essential, so everyone is doing/measuring the same thing” (P47).“I think specifying a time frame would be great - I think 24hrs is most relevant as generally babies from NICU may have had formula but…labelling as mixed feeding is not appropriate if they have transitioned back to breast milk by discharge.” (P21).“Make it as basic as possible. Feeding at discharge is literally that. If in doubt, ask the mother!” (P32).
“Being clear about ‘any’ or ‘exclusive’ is important for BFHI [Baby Friendly Hospital Initiative] data collection” (P167).
“There should definitely be obvious delineation however - for example, if a baby is BF [breastfeeding]with formula top-ups to maintain BGLs [blood glucose levels] and then exclusively breastfed from there on. If they are discharged later that same day, I would normally put BF [breastfeeding] on discharge because that is their plan. I think I go more with the intention, i.e., ‘What is the plan for this baby?‘” (P110).“Perhaps a section about feeding intentions at discharge. Some parents are only BF, [breastfeeding] but then go home and commence formula top-ups on their own” (P24).“Feeding over 24 h before discharge and feeding intention of the parents after discharge” (P105).