Mediating role of birth at a baby-friendly hospital in the association between parental socioeconomic status and infant exclusive breastfeeding at six months old.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Breast Feeding* ; Mothers*; Infant ; Female ; Humans ; Pregnancy ; Hospitals ; Postpartum Period ; Social Class

Background: Current evidence suggests that the exclusive breastfeeding (EBF) rate at six months postpartum in China falls considerably below the targets recommended by the World Health Organization (WHO). Socioeconomic disparities in EBF have been observed in developing countries, with significant heterogeneity across studies. Despite the implementation of the Baby-Friendly Hospital Initiative (BFHI) in China since the 1990s to promote breastfeeding, there has been a lack of assessment concerning infants from different socioeconomic backgrounds. This study sought to investigate the association between socioeconomic status (SES) and EBF and explore the potential impact of giving birth at a Baby-Friendly Hospital (BFH) on this association.
Methods: We analyzed data from 98,469 mother-child dyads selected from the Maternal and Child Health Management Information System. We used log-binomial models to examine the relationships between SES and EBF, SES and giving birth at a BFH, as well as BFH births and EBF. Additionally, we explored a counterfactual mediation approach to assess the mediating role of BFH births in the SES-EBF association.
Findings: We identified a significant association between SES and EBF (RR Medium vs. Low = 1.47, 95% CI 1.39-1.55; RR High vs. Low = 1.40, 95% CI 1.32-1.49). Mothers with higher SES were more likely to give birth at BFHs (RR Medium vs. Low = 1.85, 95% CI 1.81-1.88; RR High vs. Low =2.29, 95% CI 2.25-2.33). The significance of the SES-EBF association was attenuated when the type of hospital for childbirth was considered, revealing the significant mediating effect of BFH births in the SES-EBF association.
Conclusion: Socioeconomic disparities are linked to infant EBF rates, with giving birth at a BFH mediating this association, especially for cases with low SES in rural areas.
(© 2024. The Author(s).)

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81903332 National Natural Science of China Youth Foundation; 81673182 National Natural Science Foundation of China

Keywords: Association; Baby-friendly hospital; Breast feeding; Socioeconomic status

Date Created: 20240103 Date Completed: 20240105 Latest Revision: 20240117

20240117

PMC10762853

10.1186/s12889-023-17586-4

38172763