BACKGROUND:
Breastfeeding is crucial for infant health and is recommended to begin within the first hour of birth, continuing exclusively for six months. Maternity care providers play a key role in postnatal breastfeeding support. In Australia, where care is available through diverse public and private systems, early breastfeeding may be influenced by provider and hospital type, but the extent of this impact remains unclear.

OBJECTIVES:
We examined associations between type of antenatal care and intrapartum care provider, hospital type, and breastfeeding rates in Victoria, Australia.

METHODS:
We conducted a retrospective cohort study of all live, singleton term births in Victoria, Australia, from 2010 to 2020 (n = 638,809). Associations were analysed using bivariate and multivariable logistic regression.

RESULTS:
Most women (96%) initiated breastfeeding after birth, with 77% exclusively breastfeeding at the time of hospital discharge. Around 27% of infants received commercial milk formula during their hospital stay. Women who received antenatal or intrapartum care from a midwife or general practitioner showed more favourable outcomes across all three breastfeeding indicators, compared to those who received care from an obstetrician. Likewise, mother-infant dyads who received care in public hospitals had better breastfeeding outcomes than those in private hospitals. The most favourable breastfeeding outcomes were observed among those who received private midwifery care, although this group represented only a small proportion (0.2%) of the sample.

CONCLUSIONS:
Early breastfeeding outcomes in Victoria vary by healthcare provider and hospital type, reflecting disparities in breastfeeding support.

KEY MESSAGE:
Most women initiate breastfeeding after birth, but rates vary in relation to antenatal and intrapartum care provider and hospital type. Breastfeeding - support (including three-minute presentation competition)