The number of Baby Friendly hospital practices experienced by mothers is positively associated with breastfeeding: A questionnaire survey

Objectives: The objective of this study was to examine the association between number of Baby Friendly hospital practices (based on World Health Organization/United Nations Children's Fund Ten Steps to successful breastfeeding) experienced by mothers and breastfeeding initiation during hospital stay, breastfeeding at 1 month and breastfeeding at 3 months after delivery. Methods: The study population consisted of mothers who gave birth to infants without congenital anomalies at hospitals in Taiwan from June to October of 2003, inclusively. A total of 2079 mothers participated in the postal questionnaire survey. Results: Only 1% of women reported experiencing all 10-step practices, while 5.7% of women did not report experiencing any Baby Friendly practices. Mothers who delivered at certified Baby Friendly hospitals experienced more 10-step practices. The level of breastfeeding increased as the number of 10-step practices experienced increased at all three time points when confounders were controlled in the model. Conclusions: This study found a dose-response relationship between number of 10-step practices experienced and breastfeeding. However, very few women in Taiwan reported experiencing all 10 steps. Our findings highlight the need for greater attention to implement the 10 steps.