Predictors of exclusive breastfeeding at discharge, the Georgian Birth Registry

Abstract

Breastfeeding is associated with many short and long-term advantages for both mother and child, such as protection against gastrointestinal and respiratory infections in children and breast cancer in women. Rates of exclusive breastfeeding are low in low and middle-income countries. Several determinants of breastfeeding have previously been identified in the literature, for example mother’s age and social background, obstetric factors and newborn distress. Georgia has recently established a national birth registry, which includes information about early postpartum breastfeeding.

The objective of this master’s thesis was to identify predictors of exclusive breastfeeding at discharge in Georgia, in term newborns.

The study population was extracted from the Georgian Birth Registry, and consisted of all births registered in November and December 2017. The newborns included were live singletons born at term, with a final study population of n = 7 134. The group of newborns that were exclusively breastfed at discharge was compared with the group that was not exclusively breastfed at discharge, and potential predictors were assessed with logistic regression analysis.

The study identified several negative predictors of exclusive breastfeeding at discharge in Georgia in term newborns; maternal higher education compared to secondary education or less (OR 0.75 [0.59 – 0.97]), caesarean section (CS) compared to vaginal or assisted vaginal delivery (OR 0.47 [0.37 – 0.60]), low birth weight (<2500 grams) compared to a birth weight of 3000 – 3490 grams (OR 0.51 [0.27 – 0.97]), and admission to a neonatal intensive care unit after delivery (OR 0.02 [0.02 – 0.03]).

To the author’s knowledge, this is the first time determinants of breastfeeding have been studied in Georgia. The findings are of importance to the national health authorities when setting new priorities in maternal and child health, and for non-governmental organizations working to improve breastfeeding practices.