Breast-feeding intention, initiation and duration among Hong Kong Chinese women: a prospective longitudinal study

Abstract

Objectives: to (1) estimate the breast-feeding intention, initiation and duration rate; (2) identify the reasons to initiate and wean breast feeding and (3) explore predictors of breast-feeding duration.

Design: a prospective longitudinal study

Setting: antenatal clinics of five regional hospitals from four clusters in Hong Kong

Participants: a population-based sample of 2098 women in the second trimester of pregnancy was recruited with a systematic sampling method.

Measurements: three different sets of self-administered questionnaires were used to measure the breast-feeding intention, initiation and duration, demographic, socio-economic, obstetric, complications of pregnancy and intrapartum variables at three time points. Reasons for initiating and weaning breast feeding, the formal and informal supportive resources of participants during breast feeding were collated at the third time points.

Findings: the rates of artificial feeding and breast feeding were 41.1% and 58.9%, whereas breast-feeding intention and initiation rates were 85.3% and 67.0%, respectively. The breast-feeding duration rates were 11.1%, 10.3%, 10.7% and 26.7%, for the 'within <1 week', '1-3 weeks', '>3-6 weeks' and '>6 weeks' groups. The common reasons for initiating breast feeding were that breast feeding is beneficial for both the baby (89.8%) and mother (39.7%). Reasons for weaning breast feeding were insufficient breast milk (32.7%), tiredness and fatigue (39.7%) and return to work (29.6%). Partner, relatives and nurse midwives were important supportive resource during breast feeding. Ordinal logistic regression analysis identified five predictive factors of breast-feeding duration. Participants who were working part-time or were housewives (p=0.037), had monthly family income of <HK$10,000 (p=0.034), more than one child (p=0.001), positive breast-feeding intention (p=0.001) and early breast feeding within the first hour (p<0.0001) were more likely to have longer breast feeding than their counterparts.

Conclusion: mothers in Hong Kong do not meet the recommendation of the international standards for breast feeding. Understanding of reasons for initiation, weaning and predictors of breast-feeding duration can help nurse midwives to develop and customise effective strategies to promote and encourage breast feeding.

Implications for practice: the findings are important for a process-oriented breast-feeding training programme for nurse midwives. New strategies should be implemented for prolonging breast-feeding duration among perinatal women.

Keywords: Breast feeding; Duration; Initiation; Intention.