Authors (including presenting author) :
Leung YN (1), Chan LSL (1), Ngai WL(1), Lau LF (1), Lau WL (1)
Affiliation :
(1)Department of Obstetrics and Gynecology, Kwong Wah Hospital
Introduction :
The WHO and UNICEF have launched the Baby-Friendly Hospital Initiative to implement the ‘Ten Steps’, including the initiation of early skin-to-skin contact (SSC) to support breastfeeding. While the practice of SSC has significantly increased in Hong Kong, the prevalence of exclusive breastfeeding remains low, especially for Caesarean births. BFH strives to launch the Quality Improvement Initiative to overcome the challenges and barriers in meeting the standards. Additionally, there have been no local studies conducted on the effectiveness of SSC practice after Caesarean births on breastfeeding outcomes in Hong Kong. A retrospective survey was conducted.
Objectives :
To investigate the effectiveness of initiatives in enhancing SSC practice following Caesarean section on the exclusive breastfeeding rate in a birthing hospital.
Methodology :
A quality improvement initiative was implemented involving collaboration among anesthetists, operating theater nurses, obstetricians, and midwives. The Plan-Do-Check-Act (PDCA) framework was adopted in these initiatives, including revisiting enablers, streamlining workflow and protocols, and engaging staff. A retrospective survey was conducted from October to December 2024. The primary outcomes measured were the rate of SSC after Caesarean section and the exclusive breastfeeding rate before and after the initiative. Statistical analysis included odds ratios (OR), 95% confidence intervals (CI), and chi-square tests.
Result & Outcome :
Following the initiative, SSC rate after Caesarean section significantly increased from 1.14% (1/88) in October to 42.86% (42/98) in December (OR=65.25, 95% CI: 8.59-495.71, p< 0.0001). For exclusive breastfeeding, overall rates showed a modest increase from 14.91% (48/322) to 16.36% (35/214) (OR=1.116, 95% CI: 0.689-1.808, p=0.655). However, Caesarean section-specific exclusive breastfeeding rate decreased from 4.55% (4/88) to 2.74% (2/73) (OR=0.592, 95% CI: 0.100-3.501, p=0.560). The overall SSC rate increased by 41.72% after the implementation of the initiative. Conclusion: The initiative demonstrated a statistically significant and substantial improvement in SSC rate following Caesarean section. While there was a slight increase in the overall exclusive breastfeeding rate, this change was not statistically significant. These findings suggest that effective practice can enhance immediate SSC though additional strategies may be needed to improve exclusive breastfeeding rate. Further study is warranted to explore the experience and perception of mothers regarding SSC after Caesarean section and its efficacy in boosting breastfeeding confidence to support baby-friendly hospital initiative in birthing hospitals.
