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Open Access 01-12-2024 | Research

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

Authors: Hong Mei, Yuanyuan Zhang, Ruixia Chang, Ke Xu, Jianduan Zhang, Fang Wang

Published in: BMC Public Health | Issue 1/2024

Abstract

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.

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Title: Mediating role of birth at a baby-friendly hospital in the association between parental socioeconomic status and infant exclusive breastfeeding at six months old
Authors: Hong Mei
Yuanyuan Zhang
Ruixia Chang
Ke Xu
Jianduan Zhang
Fang Wang
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-023-17586-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Findings

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Findings

Conclusion

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