Factors associated with exclusive breastfeeding in Israel during the COVID-19 pandemic: a subset of the IMAgiNE EURO cross-sectional study

Rada Artzi-Medvedik, Ilaria Mariani, Emanuelle Pessa Valente*, Marzia Lazzerini, Ilana Azulay Chertok

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Evidence has shown that restrictions during the COVID-19 pandemic have negatively affected breastfeeding support and outcomes in hospitals in many countries. The aims of the study were to describe exclusive breastfeeding rates and identify factors associated with exclusive breastfeeding at hospital discharge among women who gave birth during the COVID-19 pandemic in Israel. Methods: A cross-sectional online anonymous survey based on WHO standards for improving quality of maternal and newborn care in health facilities was conducted among a sample of women who gave birth to a healthy singleton infant in Israel during the pandemic (between March 2020 and April 2022). The socio-ecological approach was employed to examine intrapersonal, interpersonal, organizational, and community/society factors associated with exclusive breastfeeding at hospital discharge according to women perspectives. Results: Among the 235 Israeli participants, 68.1% exclusively breastfed, 27.7% partially breastfed, and 4.2% did not breastfeed at discharge. Results of the adjusted logistic regression model showed that factors significantly associated with exclusive breastfeeding were the intrapersonal factor of multiparity (adjusted OR 2.09; 95% Confidence Interval 1.01,4.35) and the organizational factors of early breastfeeding in the first hour (aOR 2.17; 95% CI 1.06,4.45), and rooming-in (aOR 2.68; 95% CI 1.41,5.07). Conclusions: Facilitating early breastfeeding initiation and supporting rooming-in are critical to promoting exclusive breastfeeding. These factors, reflecting hospital policies and practices, along with parity, are significantly associated with breastfeeding outcomes and highlight the influential role of the maternity environment during the COVID-19 pandemic. Maternity care in hospitals should follow evidence-based breastfeeding recommendations also during the pandemic, promoting early exclusive breastfeeding and rooming-in among all women, with particular attention to providing lactation support to primiparous women. Trial registration: Clinical Trials NCT04847336.

Original languageEnglish
Article number30
JournalInternational Breastfeeding Journal
Volume18
Issue number1
DOIs
StatePublished - Dec 2023
Externally publishedYes

Funding

FundersFunder number
Barbara Mihevc Ponikvar38
Centre Hospitalier de Luxembourg
Department of Obstetrics and Gynecology, Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital
Department of Obstetrics and Gynecology, Region Västra Götaland
Elise de La Rochebrochard5
France 7 Department of Epidemiology and International Public Health
Generalitat de Catalunya, Spain 41 Institute of Health and Care Sciences
Genoa University
HES-SO University of Applied Sciences and Arts Western Switzerland
Institut National d’Études Démographiques
Institute for Maternal and Child Health
Instituto de Saúde Pública
KannerKlinik
Kaunas University of Applied Sciences, Lithuania 21 Kaunas Hospital of the Lithuanian University of Health Sciences
Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
Medical Anthropology Research Center
Medical School and Midwifery School
Riga Stradins University
Universidade Europeia
Vytautas Magnus University
ZHAW Zurich University
Universitetet i Tromsø
University of Maryland School of Public Health
Høgskulen på Vestlandet
Università degli Studi di Milano-Bicocca
Ministero della Salute
Universität Bielefeld
Sahlgrenska Universitetssjukhuset
Göteborgs Universitet
Sahlgrenska Akademin
Universidade de Lisboa
Universidade do Porto
Universidade Lusófona de Humanidades e Tecnologias

    Keywords

    • Breastfeeding at discharge
    • COVID-19 pandemic
    • Exclusive breastfeeding
    • Maternity care indicators

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