Breatsfeeding supression in a Spanish referral hospital (2011-17): a retrospective cohort study

Background

WHO recommends measuring the role of social determinants in the initiation of breastfeeding, given that they will have an impact on the health of these mothers and babies throughout their lives. The present study, the first in Spain, describes the onset of breastfeeding through maternal and pregnancy characteristics related to breastfeeding suppression with cabergoline.

Methods

We assessed 20965 opportunities of breastfeeding initiation, collecting data of deliveries that had an obstetric clinic history record and resulted with at least one alive baby at the Hospital Clinic of Barcelona (HCB) between January 2011 and December 2017. Adjusted odds ratios for cabergoline use during hospitalization considering maternal, neonatal and pregnancy characteristics were obtained.

Results

Adjusting for the set of variables, inhibition of lactation was significantly higher in women without or primary studies with respect to women with higher education (OR 2.5, CI95% 2.0-3.0) and living in economically more depressed areas (OR 1.08, 1.04-1.2). Breastfeeding was also more inhibited in women who did not express intention of natural birth (OR 2.3, 1.9-2.9), smokers (OR 2.2, 1.9-2.6), with more previous children (OR 1.2 for each sibling,1.1-1.3), in term versus pre-term birth (OR 1.3, 1.2-1.4), in women with multiple births (OR 1.6, 1.2-2.1) and with higher risk pregnancy (OR 1.3 per risk point, 1.2-1.4). According to the mother’s country of birth, and taking Spanish women as a reference, women born in Northern Africa (OR 0.2, 0.1-0.3), in India and Pakistan (0.2, 0.1-0.3), in Eastern Europe (0.4, 0.2-0.6) and Western Europe (0.5, 0.4-0.8) are less likely to inhibit breastfeeding. Chinese women are significantly more likelier to inhibit breastfeeding (OR 7 (5.7-8.6)).

Conclusions

Inequalities have been detected in the inhibition of lactation in puerperal women. Knowing these inequalities in breastfeeding initiation is the first step to address them.

Key messages

This is the first study to describe disparities in breastfeeding inhibition in puerperal women. Factors related to lower socioeconomic status and poor health are more likely associated with breatfeeding suppression.

Outbreak of norovirus gastroenteritis among staff at a hospital in Barcelona, Spain, September 2007

On 14 September 2007, an outbreak of acute gastroenteritis was reported among health care workers (HCW) employed at a hospital in Barcelona, Spain.