University of Oulu

Hakala, M., Kaakinen, P., Kääriäinen, M., Bloigu, R., Hannula, L., & Elo, S. (2021). Maternity ward staff perceptions of exclusive breastfeeding in Finnish maternity hospitals: A cross-sectional study. European Journal of Midwifery, 5(May), 1–11.

Maternity ward staff perceptions of exclusive breastfeeding in Finnish maternity hospitals : a cross-sectional study

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Author: Hakala, Mervi1,2; Kaakinen, Pirjo2,3; Kääriäinen, Maria1,2,3;
Organizations: 1Oulu University Hospital, Oulu, Finland
2Research Unit of Nursing Science and Health Management, Faculty of Medicine, University of Oulu, Oulu, Finland
3Medical Research Center Oulu (MRC Oulu), Faculty of Medicine, University of Oulu, Oulu, Finland
4Medical Informatics and Statistics Research Group, Medical Imaging, Physics and Technology (MIPT) Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland
5Helsinki Metropolia University of Applied Sciences, Helsinki, Finland
6Lapland University of Applied Sciences, Lapland, Finland
7University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
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Language: English
Published: European Publishing, 2021
Publish Date: 2021-10-13


Introduction: This study aimed to describe exclusive breastfeeding (EBF, Step 6 of the Baby-Friendly Hospital Initiative) in Finnish maternity hospitals and identify factors that promote or limit EBF.

Methods: A cross-sectional study design was used, and data were collected from eight maternity hospitals in Finland during a 10-day period in May 2014. The staff completed questionnaires (n=1554) from separate work shifts. The data were analyzed using descriptive statistics, and chi-squared and Fisher’s tests. Responses to open-ended questions were analyzed using content analysis.

Results: Maternity ward staff reported that 72% (n=1105) of the infants were exclusively breastfed during their work shift. The strongest promoting factors of exclusive breastfeeding were: maternity ward staffs’ profession and education in breastfeeding counselling; multiparity; vaginal delivery; early skin-to-skin contact between mother and infant; initial breastfeeding after birth; rooming-in; and initial success of breastfeeding. The use of a nipple shield, the need for additional breastfeeding counselling, and infants’ blood tests were limiting factors to exclusive breastfeeding. Open-ended answers revealed that exclusive breastfeeding was mainly delayed because of medical issues for the mother or infant.

Conclusions: Finnish maternity hospitals could improve exclusive breastfeeding rates by focusing attention and resources on breastfeeding counselling and evidence-based maternity care practices related to immediate care after birth, promoting vaginal delivery, rooming-in and availability of skilled counselling.

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Series: European journal of midwifery
ISSN: 2585-2906
ISSN-E: 2585-2906
ISSN-L: 2585-2906
Volume: 5
Pages: 1 - 11
DOI: 10.18332/EJM/134846
Type of Publication: A1 Journal article – refereed
Field of Science: 316 Nursing
Funding: This work was supported by the North Ostrobothnia Regional Fund.
Copyright information: © 2021 Hakala M. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial 4.0 International License. (