Breastfeeding at discharge or transfer from the maternity hospital: results from the German Perinatal Statistics 2021

BACKGROUND: Given the low proportion of exclusively breastfed children in Germany, breastfeeding promotion is necessary. Beginning in 2021, the nationwide mandatory quality assurance procedure for perinatal medicine in hospitals has routinely collected information on the newborn's nutrition at hospital discharge or transfer. Aims were to analyze the proportions of newborns either exclusively or partially fed with human milk, or exclusively formula-fed at hospital discharge or transfer and to identify pre- and perinatal factors potentially relevant to the newborn's nutrition. METHODS: In 2021, nutrition data at hospital discharge or transfer were available from 656,907 newborns. Prevalence rates (%) and 95% confidence intervals were calculated. RESULTS: At hospital discharge or transfer, 75.4% of newborns were exclusively fed with human milk, 18% partially, and 6.6% were exclusively formula-fed. Newborns exposed to pre- and perinatal risk factors including maternal overweight/obesity, multiple pregnancy, or cesarean section had lower rates of being exclusively fed with human milk. Proportions of newborns exclusively fed with human milk showed regional variations, with the highest rate observed in the federal state of Berlin. CONCLUSION: Data from the German Perinatal Statistics suggest that, while more efforts are needed to successfully increase the rates of exclusive breastfeeding in hospitals, certain groups of women could particularly benefit from targeted measures. The data also provide a valuable foundation for breastfeeding monitoring, health reporting, as well as future research examining associations between specific variables and newborn feeding outcomes and for the development of evidence-based breastfeeding support policies.