Benefits of the baby-friendly hospital initiative in Taiwan: Ecological correlation with breastfeeding rate
This study utilized national statistics to evaluate benefits of breastfeeding through the implementation of the Baby-Friendly Hospital Initiative (BFHI) in Taiwan. Administrative statistics on 1-, 2-, 4-, and 6-month breastfeeding rates were collected. The benefits were evaluated with health outcomes for infants and mothers, including infant and neonatal mortality, infant medical use, mean age at diagnosis and the incidence of breast and ovarian cancer. We also explore the association between breastfeeding rate and long-term maternal cancer status defined by the statistics for later 5 and 10 years. Pearson's correlation analysis and general linear regression were applied for the ecological relationship between breastfeeding rate and infant or maternal outcomes. A negative correlation was observed between infant or neonatal mortality and the breastfeeding rate. A significant inverse correlation was observed between the breastfeeding rate and medical usage for infectious diseases. In terms of long-term maternal outcomes, the mean age of breast and ovarian cancer diagnosis for 5 and 10 years later was increasing by an 1 % increase in the breastfeeding rate. Although a significant positive association was observed between the incidence of breast and ovarian cancer and the breastfeeding rate, this association tended to weaken when the 10-year period was examined. The study showed ecological trends for health benefits on children and their mothers after BFHI. Further individual level studies were required for detailed evaluation on the importance of breastfeeding.