AIM: To investigate the association between length of postpartum stay and duration of breastfeeding and breastfeeding problems, with special focus on early hospital discharge. METHODS: Swedish-speaking women were recruited from all antenatal clinics in Sweden during 3 wk evenly spread over 1 y in 1999 to 2000. In total, 3293 women (71% of those who were eligible) consented to participate in the study. Data were collected by questionnaires in early pregnancy, 2 mo and 1 y postpartum, and from the Swedish Medical Birth Register. For the purpose of this study, only data from the 2709 women (82%) who filled in the question about length of stay in the 2-mo questionnaire were analysed. Women were divided into six groups according to length of postpartum stay (day 1: or = 120 h). RESULTS: The median duration of any breastfeeding was 7 mo in women discharged on day 1, and 8 mo in women discharged on any of the following days; a non-significant difference (p = 0.66). Besides hospital policies regarding length of stay (residential area) and number of domiciliary visits, early discharge was associated with the following maternal characteristics, which could be divided into three categories: (1) older, multipara, many children; (2) positive experience of the first breastfeeding after birth; (3) low education, economic problems, smoking, lack of support from partner. Late discharge was associated with operative delivery, preterm birth and low infant birthweight. When these factors were controlled for by Cox regression analysis, no statistical differences were found between the six groups in the relative risk of discontinuing to breastfeed. Breastfeeding problems, such as engorgement and mastitis, did not differ, but women discharged on day 6 or later had fewer problems with sore or cracked nipples during the first week and more problems 4-8 wk postpartum. CONCLUSION: Maternal characteristics may be more important predictors of the duration of breastfeeding than length of stay in hospital after the birth. The effect of domiciliary support needs further research.
The father's involvement in his baby's care was studied in three groups of fathers: 49 randomly allocated to an experimental group (EG) with mother and infant discharged from hospital 24-48 h after birth, 52 allocated to a control group (CG) with traditional hospital postpartum care, and 237 randomly selected from parents not interested in participating in an evaluative study of early discharge (NPG). The ordinary length of hospital postpartum stay was 5-6 days. Fathers in EG spent more time with the baby (nappy changing, bathing, holding etc...) than fathers in CG during days 2-4 after the birth. No effect of this extended contact was observed measured as father involvement in infant care during the 2nd and 6th week after the birth, and utilization of parental leave during the first year.
Due to staff shortages in the maternity department postnatal women had to be discharged from the postnatal wards on the third day post delivery. They were given the option of discharge home on the third day following birth with domiciliary visits from a public health nurse, or transfer to another ward which was staffed by children's nurses. Previously early discharge home had been optional. Using semi-structured interviews over the telephone the effects of 'voluntary' and 'involuntary' early postnatal discharge on women's experiences of early discharge and breast feeding rates were studied in a sample of 230 women. Women discharged 'involuntarily' were more dissatisfied with early discharge and had more problems (e.g. fatigue) than women discharged 'voluntarily'. Early postnatal discharge should remain an option and should not be made compulsory.