Analysis of breastfeeding status and influencing factors among medical staff in southwestern China

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Methods A cross-sectional survey was conducted among 685 medical staff who gave birth and were weaned between January 2019 and January 2024. The questionnaire included sections on general demographics, breastfeeding knowledge, breastfeeding practices, and return-to-work timing. Univariate and multivariate logistic regression analyses were employed to identify factors influencing exclusive breastfeeding, and R software was used to construct and validate a nomogram prediction model based on the findings. Results Of the 685 participants, 363 (52.9%) exclusively breastfed for less than 6 months (Group A), while 322 (47.1%) breastfed exclusively for 6 months or longer (Group B). Univariate analysis revealed statistically significant differences between the two groups in terms of maternal income, number of deliveries, early initiation of breastfeeding within one hour post-delivery, access to breastfeeding consultation during pregnancy, earliest work shift start time, diet regularity during lactation, husband's support for breastfeeding, and family support for breastfeeding ( p < 0.05). Multivariate logistic regression analysis identified the number of deliveries, breastfeeding consultation during pregnancy, earliest start time of work shift, and family support for breastfeeding as independent factors influencing the continuation of exclusive breastfeeding for 6 months ( p < 0.05). The nomogram prediction model for successful breastfeeding showed an area under the ROC curve of 0.753 (95% CI, 0.702–0.805), demonstrating good consistency between the predicted and observed outcomes, closely approximating the ideal curve. Conclusion Medical institutions should actively establish breastfeeding consultation clinics, work to minimize maternal work hours, and promote breastfeeding education to raise societal awareness, which will help improve the exclusive breastfeeding rate for infants under 6 months of age. Exclusive breastfeeding Medical staff Influencing factors Successful breastfeeding Prediction model Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Breast milk is the optimal source of nutrition for infants and serves as a protective factor against numerous diseases in childhood. It plays a crucial role in supporting the healthy growth and development of infants[ 1 , 2 ]. Both the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) advocate for exclusive breastfeeding during the first 6 months of life[ 3 ]. In addition to providing essential nutrients for infant development, breast milk enhances immunity and strengthens the emotional bond between mother and infant[ 2 , 4 ]. Furthermore, breastfeeding has been shown to reduce the risk of postpartum depression and lower the likelihood of developing conditions such as type 2 diabetes, breast cancer, and ovarian cancer [ 5 ]. Despite the widely recognized benefits of breastfeeding, the rate of exclusive breastfeeding in our country remains low. According to recent research, the exclusive breastfeeding rate for infants under 6 months of age is only 29%, which is significantly lower than the global average of 43% [ 6 ]. To improve this rate, concerted efforts are required. As the most trusted group of medical professionals, healthcare workers play a critical role in translating scientific breastfeeding knowledge into practice, thereby improving the national breastfeeding situation. Their own breastfeeding practices have a significant influence on public attitudes and behaviors regarding breastfeeding[ 2 ]. However, medical staff face unique challenges to exclusive breastfeeding, including high work intensity, long hours, insufficient rest, and lack of private space. Currently, there is limited research on the status and influencing factors of breastfeeding among medical staff. This study aims to examine the current state of exclusive breastfeeding among healthcare workers and identify the factors influencing it, with the goal of developing a breastfeeding risk prediction model to inform effective interventions that can improve both the exclusive breastfeeding rate and duration among medical professionals. Methods Study design, setting, and population This study employed a cross-sectional survey design, collecting one-time data through a questionnaire. Medical staff from healthcare institutions at all levels in southwest China were selected as the study population. To ensure a representative sample, the study considered diversity in hospital types, sizes, and service levels, including both public and private hospitals, general and specialized hospitals, and various levels of care. The study included medical staff who gave birth between January 2019 and January 2024, with a total of 685 participants. The inclusion criteria were as follows: (1) medical staff who had delivered normally and whose delivery occurred more than 6 months prior; (2) infants who had been weaned and had no significant medical conditions; (3) individuals who voluntarily participated in the survey and signed an informed consent form. The exclusion criteria were: (1) medical staff who had given birth or were breastfeeding for less than 6 months; (2) medical staff who declined participation or did not complete the questionnaire. The research protocol was approved by the hospital ethics committee (KY S2023-080-01). This survey was anonymous, with no identifiable information collected, and the questionnaires were self-administered by the participants. Measurement A questionnaire assessing breastfeeding knowledge among medical staff was developed based on relevant literature[ 7 ]. The questionnaire comprised two sections. The general information section included questions on age, education level, family income, marital status, mode of delivery, time of return to work, and start of duty, among other factors. The breastfeeding knowledge section included questions on breastfeeding duration, whether breastfeeding was practiced during pregnancy, sources of breastfeeding information, and factors that hinder adherence to exclusive breastfeeding. The questions were input into Questionnaire Star software, and links were generated for distribution. The content validity of the questionnaire was evaluated by five obstetrics and gynecology experts, yielding a content validity index of 0.90 and a Cronbach’s α coefficient of 0.81, indicating strong content validity. Data collection The questionnaire was distributed via the WeChat Questionnaire Star platform. Respondents accessed the link to the Questionnaire Star on WeChat, completed the questionnaire anonymously, and submitted it upon completion. During data collection, the research team regularly checked the completeness and consistency of the responses to ensure data quality. The survey lasted for one week. At the conclusion of the survey, a total of 685 valid questionnaires were collected, resulting in an effective response rate of 100%. Statistical methods All questionnaire data were summarized and entered into Excel software to establish a database, with SPSS 26.0 software used for statistical analysis. If the data for a variable followed a normal distribution, it was expressed as the mean ± SD, and an independent sample t-test was used for group comparisons. If the data did not follow a normal distribution, it was expressed as the median ± interquartile range, and the Mann–Whitney U test was applied for group comparisons. Categorical variables were expressed as frequencies and percentages, and comparisons between groups were performed using the χ² test. Logistic regression analysis was used for multivariate analysis, with p < 0.05 considered statistically significant. The nomogram model based on the optimal logistic model was constructed using the R platform's nomogramFormula package (v1.2.0.0). The model's concordance index (C-index), sensitivity, specificity, and accuracy were calculated to evaluate the prediction performance. After 1,000 repetitions of Bootstrap resampling, a calibration curve was plotted to assess the model's calibration. A p -value of < 0.05 was considered to indicate a statistically significant difference. Results General situation of medical staff participating in the survey This study examined the characteristics of 685 medical staff members, including education level, hospital grade, department, job position, marital status, annual household income, and maternity leave duration. Details are provided in Table 1 . Table 1 General information of medical staff participating in the survey (n = 685) Project Classification Number of people(n) Proportion(%) Age 20–29 130 19.0 30–39 412 60.1 over 40 143 20.9 Education level College 79 11.5 Bachelor 552 80.6 Master 46 6.7 Doctoral 8 1.2 Hospital grade Primary 503 73.4 Secondary 133 19.4 Tertiary 24 3.5 Undetermined grade 25 3.6 Ethnic group Han nationality 620 90.5 Ethnic minority 65 9.5 Hospital department Internal Medicine Department 124 18.1 Surgery 229 33.4 Specialty 143 20.9 Medical technology department 64 9.3 Operating Room 30 4.4 Intensive Care Unit 17 2.5 Outpatient Department 27 3.9 administration and logistic departments 51 7.4 Profession Doctor. 159 23.2 Nurse 464 67.7 Medical health technical staff 36 5.3 Non-clinical medical staff 26 3.8 Marital status Married 672 98.1 Unmarried 2 0.3 Divorced 11 1.6 Annual household income Less than 100,000 ¥ 130 19.0 100,000-200,000 ¥ 313 45.7 More than 200,000 ¥ 242 35.3 Gender of infant Male 357 52.1 Female 307 44.8 Twins (male) 9 1.3 Twins (female) 4 0.6 Boy-girl twins 8 1.2 Maternity leave Within 4 months 239 34.9 4–6 months 331 48.3 More than 6 months 115 16.8 Maternity and childbirth status of medical staff participating in the survey Among the 685 medical staff members who participated in the survey, 82 (12.0%) experienced complications during pregnancy; 553 had natural pregnancies (80.7%); 473 were first-time mothers (69.0%), while 201 were second-time mothers (29.3%), and 11 had three or more births (1.6%). Of the participants, 333 (48.6%) had vaginal deliveries, 308 (45.0%) underwent cesarean sections, 44 (6.4%) experienced failed vaginal deliveries that were converted to cesarean sections, and 38 (5.5%) had postpartum hemorrhage. Details are provided in Table 2 . Table 2 Pregnancy and childbirth status of medical staff participating in the survey (n = 685) Project Classification Number of people(n) Proportion(%) Complication of pregnancy Yes 82 12.0 No 603 88.0 Natural pregnan Yes 553 80.7 No 132 19.3 Number of deliveries 1 473 69.1 2 201 29.3 ≥ 3 11 1.6 Last delivery Singleton 666 97.2 Twins 19 2.8 Triplets or more 0 Premature birth Yes 51 7.4 No 634 92.6 Mode of delivery Vaginal delivery 333 48.6 Cesarean section 308 45.0 Failure of vaginal delivery and conversion to cesarean section 44 6.4 Postpartum hemorrhage Yes 38 5.5 No 647 94.5 Breastfeeding knowledge among medical staff participating in the survey In this study, the Internet was identified as the primary source of breastfeeding knowledge, accounting for the largest proportion at 80%, followed by consultations with professionals at approximately 70%. Breastfeeding knowledge obtained from books, documents, and guides accounted for around 60%, while peer communication contributed to about 50%. Other sources represented the smallest proportion, at only about 10%. Details are provided in Fig. 1 A. Among the factors contributing to breastfeeding difficulties, nipple and breast-related issues accounted for the highest proportion at 60%, followed by work-related factors at 50%. Milk volume issues also represented a significant proportion, at approximately 45%, while milk storage problems accounted for 35%. Lack of breastfeeding knowledge contributed to 20%, and other factors accounted for the smallest proportion at 10%. These findings suggest that nipple and breast problems, as well as work-related factors, are the most common breastfeeding difficulties among medical staff, whereas lack of knowledge and other factors are relatively less frequent. Details are provided in Fig. 1 B. Single-factor analysis of the impact of exclusive breastfeeding duration among medical staff participating in the survey The WHO recommends that the exclusive breastfeeding rate for infants under 6 months of age should exceed 50%. Based on the duration of exclusive breastfeeding, among the 685 medical staff mothers, 363 (52.9%) exclusively breastfed for less than 6 months, while 322 (48.1%) exclusively breastfed for 6 months or longer. The results of univariate analysis showed statistically significant differences (P < 0.05) between the two groups in terms of family income, number of deliveries, initiation of breastfeeding within one hour after delivery, consultation with breastfeeding clinics during pregnancy, earliest return to work, regularity of diet during lactation, husband's support for breastfeeding, and support from other family members. These findings are summarized in Table 3 . Table 3 Single factor analysis of the influence of exclusive breastfeeding duration among medical staff participating in the survey Category Group Exclusive breastfeeding for less than 6 months(n = 363 ) Exclusive breastfeeding for more than 6 months (n = 322) χ 2 p Annual household income Less than 100,000¥ 67(18.4) 63(19.6) 8.704 0.013 100,000-200,000¥ 184(50.7) 129(40.0) More than 200,000¥ 112(30.9) 130(40.4) Number of deliveries 1 274(75.5) 199(61.8) 2 86(23.7) 115(35.7) 15.952 <0.001 ≥ 3 3(0.8) 8(2.5) Early initiation of breastfeeding within one hour post-delivery Yes 281(77.4) 281(87.3) 11.253 0.001 No 82(22.6) 41(33.3) Access to breastfeeding consultation during pregnancy Yes 162(44.6) 176(54.7) 6.868 0.009 No 201(55.4) 146(45.3) Earliest work shift start time Less than 6 months 143(39.4) 86(26.7) 18.468 <0.001 Over 12 mongths 166(45.7) 153(47.5) Off duty 54(14.9) 83(25.8) Diet regularity during lactation Yes 256(70.5) 263(81.7) 11.561 0.001 No 107(29.5) 59(18.3) Husband's support for breastfeeding Supportive attitude 309(85.1) 300(93.2) 11.544 0.003 Neutral attitude 25(6.9) 12(3.7) Indifferent attitude 29(8.0) 10(3.1) Family support for breastfeeding Supportive attitude 313(86.2) 309(96.0) 20.467 <0.001 Neutral attitude 29(8.0) 10(3.1) Indifferent attitude 21(5.8) 3(0.9) Multi-factor analysis of factors influencing the duration of exclusive breastfeeding among medical staff participating in the survey The results of multivariate logistic regression analysis identified four independent risk factors influencing the continuation of exclusive breastfeeding for 6 months among medical staff: number of deliveries, consultation with breastfeeding clinics during pregnancy, earliest return to work, and family support for breastfeeding (P < 0.05). These findings are presented in Table 4 . Table 4 Multi-factor analysis of medical staff participating in the survey on exclusive breastfeeding for 6 months Factor β p OR 95%CI Annual household income 0.21 0.063 1.236 0.989–1.546 Number of deliveries 0.632 0.001 1.881 1.360–2.602 Early initiation of breastfeeding within one hour post-delivery -0.414 0.067 0.661 0.425–1.029 Access to breastfeeding consultation during pregnancy -0.360 0.032 0.698 0.503–0.969 Earliest work shift start time 0.512 <0.001 1.668 1.322–2.105 Diet regularity during lactation -0.351 0.077 0.704 0.477–1.039 Husband's support for breastfeeding 0.037 0.877 1.037 0.654–1.645 Family support for breastfeeding -0.934 0.003 0.393 0.212–0.729 Construct a nomogram prediction model for medical staff to continue exclusive breastfeeding for 6 months The four independent predictive factors identified through multivariate logistic regression analysis were incorporated into the construction of the nomogram model (see Fig. 2 ). Each independent variable was assigned a specific score, which was then compared with the corresponding total score axis. The total score was obtained by summing the individual scores. A higher total score indicates a greater likelihood of exclusive breastfeeding for 6 months. For further details, see Fig. 2 . Validation of the effect of the nomogram prediction model The effectiveness of the nomogram prediction model was assessed using the validation set data from the study subjects. The area under the curve (AUC) of the nomogram model was 0.753 (95% CI: 0.702–0.805), indicating good discrimination. The calibration curve was used to assess the model’s calibration, with the predicted probability curve closely aligning with the observed frequency curve. This demonstrates strong consistency and a good fit to the ideal curve, suggesting the model’s accuracy is high (see Fig. 3 , Fig. 4 ). Discussion The WHO and the UNICEF advocate breastfeeding as a key strategy for promoting human health[ 8 ]. Breast milk is the preferred choice for all newborns, regardless of whether they are premature or full-term. WHO and UNICEF recommend exclusive breastfeeding for at least six months, followed by continued breastfeeding for up to two years, alongside complementary foods[ 9 ]. The findings of this study indicate that approximately 48.1% of medical staff exclusively breastfeed for more than six months, which exceeds the global average of 43%[ 6 ]. This suggests that medical staff generally possess a strong understanding of breastfeeding. They typically receive comprehensive medical education and training, equipping them with a thorough knowledge of the importance of breastfeeding. As a result, they are proficient in breastfeeding techniques, aware of its benefits, and capable of addressing challenges that may arise during breastfeeding. Furthermore, they often have access to various resources to seek assistance. These factors, including solid knowledge, a deep understanding of breastfeeding, and increased access to support, likely contribute to higher breastfeeding success rates and longer breastfeeding durations. This study indicates that, similar to common breastfeeding challenges, medical staff also encounter several difficulties during the breastfeeding process. Nipple and breast issues are the most prevalent, affecting up to 60% of medical staff. This suggests that, despite their professional knowledge, medical staff may still face technical challenges during breastfeeding and require additional practical guidance and support. It also highlights the need for breastfeeding consultation clinics. Work-related factors represent another significant challenge, affecting 50% of participants. This issue is primarily due to the negative impact of work pressures and schedules on breastfeeding, particularly after returning to work, when the working environment and conditions may hinder breastfeeding continuation. To improve breastfeeding success rates and durations, it is recommended to provide better lactation support facilities in the workplace, encourage medical staff to actively engage in prenatal breastfeeding counseling, and offer systematic breastfeeding education in the delivery ward. Additionally, technical training to address potential breastfeeding challenges should be provided in advance. The number of deliveries, breastfeeding clinic consultations during pregnancy, the work shift start time, and family support are independent factors influencing medical staff's ability to continue exclusive breastfeeding for six months. Mothers with multiple previous births possess greater experience and confidence in breastfeeding, which enables them to better manage related challenges, thus prolonging the duration of exclusive breastfeeding. A qualitative study found that confidence plays a key role in helping mothers persevere during difficult moments in their breastfeeding journey[ 10 ]. Additionally, there is a significant positive correlation between maternal confidence levels and both the extent and duration of breastfeeding[ 11 ]. The results of this study indicate that the earlier the return to work, the shorter the duration of exclusive breastfeeding. Mothers returning to work may experience stress related to balancing work and motherhood, which can inhibit the lactation reflex and lead to insufficient milk production[ 12 ]. A survey on domestic anesthetists (n = 1364) found that 96.1% reported a decrease in lactation after returning to work[ 13 ]. Among the 1161 anesthesiologists who ceased breastfeeding, 836 (72.0%) failed to meet their breastfeeding goals due to professional factors. Furthermore, most mothers who return to work completely discontinue breastfeeding within a month [ 14 ]. Studies and others have shown that the exclusive breastfeeding rate is significantly higher among non-working women compared to working women[ 15 , 16 ]. These studies suggest that the timing of return to work has a significant impact on the continuation of exclusive breastfeeding. The family support system is a key factor influencing the duration of breastfeeding. Our study demonstrates that family support plays a significant role in the duration of exclusive breastfeeding among healthcare workers. Previous study have also emphasized that family support is crucial for extending the duration of exclusive breastfeeding [ 17 ]. Similarly, research by Dib et al. [ 18 ] indicated that enhanced family support can reduce the incidence of breastfeeding problems and prolong breastfeeding duration. Furthermore, Chang et al. [ 19 ]found that full support from family members is essential for promoting breastfeeding. Therefore, it is important to increase the dissemination of breastfeeding knowledge and improve the cognitive and practical capabilities of families, thereby increasing the rate and duration of exclusive breastfeeding. This study successfully developed a nomogram prediction model, with internal validation results demonstrating good discrimination and accuracy. In clinical practice, the nomogram should be used to assign scores to patients based on relevant factors, and the probability of successful breastfeeding should be evaluated according to the total score. This approach can guide early clinical interventions, facilitating the adoption of targeted measures to improve breastfeeding success rates and duration. This study has several limitations. First, due to time and resource constraints, the sample size was relatively small. Second, random sampling was not employed, and some mothers who exclusively formula-fed declined to participate, potentially introducing selection bias. Additionally, data regarding the duration of exclusive breastfeeding among medical staff were based on maternal recall, which may introduce recall bias. Future research should involve a larger, more rigorously designed study with random sampling to better estimate the prevalence of exclusive breastfeeding. Currently, most studies on the factors influencing breastfeeding among medical staff are cross-sectional in nature. It is recommended that future research adopt cohort study designs to track these influencing factors more effectively. In summary, this study identified several factors influencing exclusive breastfeeding among medical staff, including the number of deliveries, breastfeeding consultation during pregnancy, the earliest work shift start time, and family support. To increase the prevalence of exclusive breastfeeding among medical staff, it is essential to enhance breastfeeding consultation services during pregnancy, optimize work arrangements, provide appropriate breastfeeding support facilities, and encourage family involvement in supporting breastfeeding. These measures can effectively extend breastfeeding duration, thereby promoting the health of both medical staff and their infants. Future research should further investigate the specific mechanisms underlying these factors and validate the findings on a larger scale to develop more effective interventions. Abbreviations WHO World Health Organization UNICEF United Nations Children's Fund SD Standard Deviation AUC Area Under Curve Declarations Acknowledgements Not applicable. Author contributions Tingting Dai: led the article design, data collection and analysis, and wrote the first draft. Jiaxin Wan: assisted in questionnaire design, questionnaire sending and receiving and data collection, and participated in translation proofreading. Qiuyue Liu: reviewed the literature, participated in the revision and improvement of the first draft, and proofread the references. Cheng Chen: provided funding for resources, guided the research and paper writing, and was responsible for communicating with journals.Xiaoyan Liu: Expanded the sample scope, promoted the research results, optimized the language of the paper and assisted in the submission follow-up. Funding Chongqing Science and Technology Communication and Popularization Project （cstc2023kpzx-kpzpBX0022),Chongqing Medical Leading Talent Project（YXLJ202416） Data availability The data and materials supporting the findings in this study are available from the corresponding author upon request. Ethics approval and consent to participate The study protocol was approved by the Ethics Committee of Chongqing General Hospital (KY S2023-080-01). All participants provided informed consent. Consent for publication Consent to publish is not required. Conflicts of interest All authors are without conflicts of interest, including specific financial interests, relationships, and affiliations relevant to the subject of their manuscript. References Prentice AM: Breastfeeding in the modern world . ANN NUTR METAB 2022, 78 (Suppl. 2):29-38. North K, Gao M, Allen G, Lee AC: Breastfeeding in a global context: epidemiology, impact, and future directions . CLIN THER 2022, 44 (2):228-244. Hollis JL, Collins CE, DeClerck F, Chai LK, McColl K, Demaio AR: Defining healthy and sustainable diets for infants, children and adolescents . Global Food Security 2020, 27 :100401. Tucker Z, O Malley C: Mental health benefits of breastfeeding: a literature review . Cureus 2022, 14 (9). Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, Griffen A, McIntyre L, Byatt N, Moore Simas TA: The effects of breastfeeding on maternal mental health: a systematic review . Journal of women's health 2022, 31 (6):787-807. Liu K, Guo J, Deng W, Su Y: The Current Status of Breastfeeding Knowledge and Its Influencing Factors in Nursing Undergraduates: A Cross-Sectional Study in China . INT J ENV RES PUB HE 2022, 20 (1):103. Mulcahy H, Philpott LF, O'Driscoll M, Bradley R, Leahy-Warren P: Breastfeeding skills training for health care professionals: A systematic review . Heliyon 2022, 8 (11). Gupta A, Suri S, Dadhich JP, Trejos M, Nalubanga B: The world breastfeeding trends initiative: implementation of the global strategy for infant and young child feeding in 84 countries . J PUBLIC HEALTH POL 2019, 40 (1):35-65. Alayón S, Varela V, Mukuria Ashe A, Alvey J, Milner E, Pedersen S, Yourkavitch J: Exclusive breastfeeding: Measurement to match the global recommendation . Maternal & child nutrition 2022, 18 (4):e13409. Hacking M, Jackson L, Fallon V, Harrold JA, Davie P, Silverio SA, Slade P: An interpretive phenomenological analysis of the experiences of mothers who continue to breastfeed despite facing difficulties . WOMEN BIRTH 2024, 37 (2):387-393. Moraes GGWD, Christoffel MM, Toso BRGD, Viera CS: Association between duration of exclusive breastfeeding and nursing mothers ’ self-efficacy for breastfeeding . REV ESC ENFERM USP 2021, 55 :e3702. Ahmad RS, Sulaiman Z, Nik Hussain NH, Mohd Noor N: Working mothers ’ breastfeeding experience: a phenomenology qualitative approach . BMC PREGNANCY CHILDB 2022, 22 (1):85. Xu X, Wang R, Zhang Y, Li J, Li H, Yu X, Zhang J, Li X, Huang Y: Occupational factors associated with time to breastfeeding discontinuation after return to work among female anesthesiologists in China: a nationwide survey . Anesthesia & Analgesia 2024, 139 (1):135-143. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A, Narwal R, Adler A, Garcia CV, Rohde S, Say L: National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications . The lancet 2012, 379 (9832):2162-2172. Ngao OD, Mboineki JF: Comparative study of exclusive breastfeeding practice among employed mothers and housewives in Tanzania . Journal of Health, Population and Nutrition 2023, 42 (1):72. Bhandari MS, Manandhar P, Tamrakar D: Practice of breastfeeding and its barriers among women working in tertiary level hospitals . JNMA: Journal of the Nepal Medical Association 2019, 57 (215):8. Xianlin W, Yuqi F, Tuanmei W, Zhuan Y, Lijuan X, Hongyan L, Fang P, Juan W: Analysis of the duration of exclusive breastfeeding in premature infants and its influencing factors . Journal of Pediatric Nursing 2023, 73 :e180-e186. Dib S, Fewtrell M, Wells JC, Shukri NHM: The influence of hospital practices and family support on breastfeeding duration, adverse events, and postnatal depression among first-time mothers . Malaysian Journal of Medicine and Health Sciences 2020, 16 (6):90-98. Chang Y, Li KMC, Li KYC, Beake S, Lok KYW, Bick D: Relatively speaking? Partners' and family members ’ views and experiences of supporting breastfeeding: a systematic review of qualitative evidence . Philosophical Transactions of the Royal Society B 2021, 376 (1827):20200033. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 25 Jul, 2025 Read the published version in International Breastfeeding Journal → Version 1 posted Editorial decision: Revision requested 02 Feb, 2025 Reviews received at journal 29 Jan, 2025 Reviews received at journal 22 Jan, 2025 Reviews received at journal 17 Jan, 2025 Reviewers agreed at journal 11 Jan, 2025 Reviewers agreed at journal 09 Jan, 2025 Reviewers agreed at journal 07 Jan, 2025 Reviewers agreed at journal 06 Jan, 2025 Reviewers invited by journal 04 Jan, 2025 Editor assigned by journal 30 Dec, 2024 Submission checks completed at journal 30 Dec, 2024 First submitted to journal 29 Dec, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYDACCSBmbAAS7M0HDnwwsJEjQQvPscSDMwrSjEnQIpGjfJjnw+FEgjr4Zzcfe/Bzh02efEQOw2EbA+YEBvbDRzfgteTOsXTD3jNpxYZn3h44nGPAlsfAk5Z2A58WA4kcM2nGtsOJG9vzEoBaeIoZJHjMCGjJ/wbU8j9xY0OOwWELA4nEBsJactiAWg4kzucAamEwMCCsReJGmplkb1ty4gaeYwkHewwSjNkI+YV/RvIziZ9tdonz25sPf/jx578cP/vhY3i1IFx4AMpgI0o5CMg3EK10FIyCUTAKRhoAAPQWUFOdTm1qAAAAAElFTkSuQmCC","orcid":"","institution":"Chongqing General Hospital, Chongqing University","correspondingAuthor":true,"prefix":"","firstName":"Cheng","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2024-12-29 14:23:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5730401/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5730401/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s13006-025-00757-x","type":"published","date":"2025-07-25T15:57:28+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":72740040,"identity":"4a4ca724-39d3-4b7f-a5fb-c1ee80236ed1","added_by":"auto","created_at":"2025-01-01 09:28:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":53058,"visible":true,"origin":"","legend":"\u003cp\u003eBreastfeeding knowledge among medical staff participating in the survey\u003c/p\u003e\n\u003cp\u003eFigure 1 (A) Sources of breastfeeding knowledge Figure 1 (B) Difficulties of breastfeeding itself\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5730401/v1/5e18e68cbdba56b2f4410dff.png"},{"id":72740042,"identity":"3c38efc8-66d0-4fcc-b449-422789892faa","added_by":"auto","created_at":"2025-01-01 09:28:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":55135,"visible":true,"origin":"","legend":"\u003cp\u003eNomogram prediction model for continued exclusive breastfeeding for 6 months among medical staff\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5730401/v1/c706cf47d198a616501c5cb2.png"},{"id":72740041,"identity":"b98d217e-c528-4c9f-84e4-d922a0cb8eb4","added_by":"auto","created_at":"2025-01-01 09:28:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":36091,"visible":true,"origin":"","legend":"\u003cp\u003eSpecificity of the nomogram model for exclusive breastfeeding for 6 months among medical staff\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5730401/v1/5a36c9b6ab0e51e5a3acdf7c.png"},{"id":72740043,"identity":"64e10a33-d484-4483-8454-2cf48f49269e","added_by":"auto","created_at":"2025-01-01 09:28:03","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":66912,"visible":true,"origin":"","legend":"\u003cp\u003ePredicted probability of nomogram model for exclusive breastfeeding for 6 months by medical staff\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-5730401/v1/661919a68afaf3f15c5722d7.png"},{"id":87756679,"identity":"c56fc917-5fb6-4d32-903d-c7ab89e9ef1f","added_by":"auto","created_at":"2025-07-28 16:07:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2206860,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5730401/v1/96eca6ae-9daa-47e2-aab1-3b84f6aed610.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of breastfeeding status and influencing factors among medical staff in southwestern China","fulltext":[{"header":"Background","content":"\u003cp\u003eBreast milk is the optimal source of nutrition for infants and serves as a protective factor against numerous diseases in childhood. It plays a crucial role in supporting the healthy growth and development of infants[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Both the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) advocate for exclusive breastfeeding during the first 6 months of life[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In addition to providing essential nutrients for infant development, breast milk enhances immunity and strengthens the emotional bond between mother and infant[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Furthermore, breastfeeding has been shown to reduce the risk of postpartum depression and lower the likelihood of developing conditions such as type 2 diabetes, breast cancer, and ovarian cancer [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the widely recognized benefits of breastfeeding, the rate of exclusive breastfeeding in our country remains low. According to recent research, the exclusive breastfeeding rate for infants under 6 months of age is only 29%, which is significantly lower than the global average of 43% [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. To improve this rate, concerted efforts are required. As the most trusted group of medical professionals, healthcare workers play a critical role in translating scientific breastfeeding knowledge into practice, thereby improving the national breastfeeding situation. Their own breastfeeding practices have a significant influence on public attitudes and behaviors regarding breastfeeding[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. However, medical staff face unique challenges to exclusive breastfeeding, including high work intensity, long hours, insufficient rest, and lack of private space. Currently, there is limited research on the status and influencing factors of breastfeeding among medical staff. This study aims to examine the current state of exclusive breastfeeding among healthcare workers and identify the factors influencing it, with the goal of developing a breastfeeding risk prediction model to inform effective interventions that can improve both the exclusive breastfeeding rate and duration among medical professionals.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design, setting, and population\u003c/h2\u003e \u003cp\u003eThis study employed a cross-sectional survey design, collecting one-time data through a questionnaire. Medical staff from healthcare institutions at all levels in southwest China were selected as the study population. To ensure a representative sample, the study considered diversity in hospital types, sizes, and service levels, including both public and private hospitals, general and specialized hospitals, and various levels of care. The study included medical staff who gave birth between January 2019 and January 2024, with a total of 685 participants. The inclusion criteria were as follows: (1) medical staff who had delivered normally and whose delivery occurred more than 6 months prior; (2) infants who had been weaned and had no significant medical conditions; (3) individuals who voluntarily participated in the survey and signed an informed consent form. The exclusion criteria were: (1) medical staff who had given birth or were breastfeeding for less than 6 months; (2) medical staff who declined participation or did not complete the questionnaire. The research protocol was approved by the hospital ethics committee (KY S2023-080-01). This survey was anonymous, with no identifiable information collected, and the questionnaires were self-administered by the participants.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasurement\u003c/h3\u003e\n\u003cp\u003eA questionnaire assessing breastfeeding knowledge among medical staff was developed based on relevant literature[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The questionnaire comprised two sections. The general information section included questions on age, education level, family income, marital status, mode of delivery, time of return to work, and start of duty, among other factors. The breastfeeding knowledge section included questions on breastfeeding duration, whether breastfeeding was practiced during pregnancy, sources of breastfeeding information, and factors that hinder adherence to exclusive breastfeeding. The questions were input into Questionnaire Star software, and links were generated for distribution. The content validity of the questionnaire was evaluated by five obstetrics and gynecology experts, yielding a content validity index of 0.90 and a Cronbach\u0026rsquo;s α coefficient of 0.81, indicating strong content validity.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eThe questionnaire was distributed via the WeChat Questionnaire Star platform. Respondents accessed the link to the Questionnaire Star on WeChat, completed the questionnaire anonymously, and submitted it upon completion. During data collection, the research team regularly checked the completeness and consistency of the responses to ensure data quality. The survey lasted for one week. At the conclusion of the survey, a total of 685 valid questionnaires were collected, resulting in an effective response rate of 100%.\u003c/p\u003e\n\u003ch3\u003eStatistical methods\u003c/h3\u003e\n\u003cp\u003eAll questionnaire data were summarized and entered into Excel software to establish a database, with SPSS 26.0 software used for statistical analysis. If the data for a variable followed a normal distribution, it was expressed as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD, and an independent sample t-test was used for group comparisons. If the data did not follow a normal distribution, it was expressed as the median\u0026thinsp;\u0026plusmn;\u0026thinsp;interquartile range, and the Mann\u0026ndash;Whitney U test was applied for group comparisons. Categorical variables were expressed as frequencies and percentages, and comparisons between groups were performed using the χ\u0026sup2; test. Logistic regression analysis was used for multivariate analysis, with \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05 considered statistically significant. The nomogram model based on the optimal logistic model was constructed using the R platform's nomogramFormula package (v1.2.0.0). The model's concordance index (C-index), sensitivity, specificity, and accuracy were calculated to evaluate the prediction performance. After 1,000 repetitions of Bootstrap resampling, a calibration curve was plotted to assess the model's calibration. A \u003cem\u003ep\u003c/em\u003e-value of \u0026lt;\u0026thinsp;0.05 was considered to indicate a statistically significant difference.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eGeneral situation of medical staff participating in the survey\u003c/h2\u003e \u003cp\u003eThis study examined the characteristics of 685 medical staff members, including education level, hospital grade, department, job position, marital status, annual household income, and maternity leave duration. Details are provided in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGeneral information of medical staff participating in the survey (n\u0026thinsp;=\u0026thinsp;685)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of people(n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProportion(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e412\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eover 40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctoral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e503\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e73.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndetermined grade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHan nationality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e620\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e90.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEthnic minority\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospital department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInternal Medicine Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e33.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpecialty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical technology department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOperating Room\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntensive Care Unit\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOutpatient Department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eadministration and logistic departments\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e464\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedical health technical staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNon-clinical medical staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e672\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnnual household income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 100,000 \u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100,000-200,000 \u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e313\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 200,000 \u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender of infant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e357\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwins (male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwins (female)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoy-girl twins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaternity leave\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin 4 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u0026ndash;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMaternity and childbirth status of medical staff participating in the survey\u003c/h3\u003e\n\u003cp\u003eAmong the 685 medical staff members who participated in the survey, 82 (12.0%) experienced complications during pregnancy; 553 had natural pregnancies (80.7%); 473 were first-time mothers (69.0%), while 201 were second-time mothers (29.3%), and 11 had three or more births (1.6%). Of the participants, 333 (48.6%) had vaginal deliveries, 308 (45.0%) underwent cesarean sections, 44 (6.4%) experienced failed vaginal deliveries that were converted to cesarean sections, and 38 (5.5%) had postpartum hemorrhage. Details are provided in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePregnancy and childbirth status of medical staff participating in the survey (n\u0026thinsp;=\u0026thinsp;685)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClassification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNumber of people(n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eProportion(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplication of pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e603\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNatural pregnan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of deliveries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e473\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLast delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingleton\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e666\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e97.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTwins\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTriplets or more\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePremature birth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e92.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMode of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVaginal delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e308\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFailure of vaginal delivery and conversion to cesarean section\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePostpartum hemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e647\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e94.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eBreastfeeding knowledge among medical staff participating in the survey\u003c/h3\u003e\n\u003cp\u003eIn this study, the Internet was identified as the primary source of breastfeeding knowledge, accounting for the largest proportion at 80%, followed by consultations with professionals at approximately 70%. Breastfeeding knowledge obtained from books, documents, and guides accounted for around 60%, while peer communication contributed to about 50%. Other sources represented the smallest proportion, at only about 10%. Details are provided in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA.\u003c/p\u003e \u003cp\u003eAmong the factors contributing to breastfeeding difficulties, nipple and breast-related issues accounted for the highest proportion at 60%, followed by work-related factors at 50%. Milk volume issues also represented a significant proportion, at approximately 45%, while milk storage problems accounted for 35%. Lack of breastfeeding knowledge contributed to 20%, and other factors accounted for the smallest proportion at 10%. These findings suggest that nipple and breast problems, as well as work-related factors, are the most common breastfeeding difficulties among medical staff, whereas lack of knowledge and other factors are relatively less frequent. Details are provided in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB.\u003c/p\u003e \u003cp\u003e \u003cb\u003eSingle-factor analysis of the impact of exclusive breastfeeding duration among medical staff participating in the survey\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe WHO recommends that the exclusive breastfeeding rate for infants under 6 months of age should exceed 50%. Based on the duration of exclusive breastfeeding, among the 685 medical staff mothers, 363 (52.9%) exclusively breastfed for less than 6 months, while 322 (48.1%) exclusively breastfed for 6 months or longer. The results of univariate analysis showed statistically significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) between the two groups in terms of family income, number of deliveries, initiation of breastfeeding within one hour after delivery, consultation with breastfeeding clinics during pregnancy, earliest return to work, regularity of diet during lactation, husband's support for breastfeeding, and support from other family members. These findings are summarized in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSingle factor analysis of the influence of exclusive breastfeeding duration among medical staff participating in the survey\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGroup\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eExclusive breastfeeding for less than 6 months(n\u0026thinsp;=\u0026thinsp;363 )\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExclusive breastfeeding\u0026nbsp;for more than 6 months\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;322)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnnual household income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 100,000\u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67(18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63(19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.704\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100,000-200,000\u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e184(50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e129(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than 200,000\u0026yen;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112(30.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130(40.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of deliveries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e274(75.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e199(61.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86(23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e115(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15.952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEarly initiation of breastfeeding within one hour post-delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e281(77.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e281(87.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.253\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82(22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41(33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAccess to breastfeeding consultation during pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162(44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e176(54.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6.868\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201(55.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e146(45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEarliest work shift start time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLess than 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e143(39.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86(26.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18.468\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOver 12 mongths\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e166(45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e153(47.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOff duty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54(14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e83(25.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDiet regularity during lactation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e256(70.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e263(81.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e107(29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59(18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHusband's support for breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSupportive attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e309(85.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e300(93.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.544\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25(6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12(3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndifferent attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29(8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFamily support for breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSupportive attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e313(86.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e309(96.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20.467\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNeutral attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29(8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIndifferent attitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21(5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eMulti-factor analysis of factors influencing the duration of exclusive breastfeeding among medical staff participating in the survey\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe results of multivariate logistic regression analysis identified four independent risk factors influencing the continuation of exclusive breastfeeding for 6 months among medical staff: number of deliveries, consultation with breastfeeding clinics during pregnancy, earliest return to work, and family support for breastfeeding (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). These findings are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMulti-factor analysis of medical staff participating in the survey on exclusive breastfeeding for 6 months\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFactor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnnual household income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.989\u0026ndash;1.546\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of deliveries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.881\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.360\u0026ndash;2.602\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly initiation of breastfeeding within one hour post-delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.661\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.425\u0026ndash;1.029\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAccess to breastfeeding consultation during pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.360\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.698\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.503\u0026ndash;0.969\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarliest work shift start time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.512\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e\u0026lt;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.668\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.322\u0026ndash;2.105\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiet regularity during lactation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.704\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.477\u0026ndash;1.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHusband's support for breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.877\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.654\u0026ndash;1.645\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFamily support for breastfeeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.934\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.393\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.212\u0026ndash;0.729\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eConstruct a nomogram prediction model for medical staff to continue exclusive breastfeeding for 6 months\u003c/h2\u003e \u003cp\u003eThe four independent predictive factors identified through multivariate logistic regression analysis were incorporated into the construction of the nomogram model (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Each independent variable was assigned a specific score, which was then compared with the corresponding total score axis. The total score was obtained by summing the individual scores. A higher total score indicates a greater likelihood of exclusive breastfeeding for 6 months. For further details, see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eValidation of the effect of the nomogram prediction model\u003c/h2\u003e \u003cp\u003eThe effectiveness of the nomogram prediction model was assessed using the validation set data from the study subjects. The area under the curve (AUC) of the nomogram model was 0.753 (95% CI: 0.702\u0026ndash;0.805), indicating good discrimination. The calibration curve was used to assess the model\u0026rsquo;s calibration, with the predicted probability curve closely aligning with the observed frequency curve. This demonstrates strong consistency and a good fit to the ideal curve, suggesting the model\u0026rsquo;s accuracy is high (see Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe WHO and the UNICEF advocate breastfeeding as a key strategy for promoting human health[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Breast milk is the preferred choice for all newborns, regardless of whether they are premature or full-term. WHO and UNICEF recommend exclusive breastfeeding for at least six months, followed by continued breastfeeding for up to two years, alongside complementary foods[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The findings of this study indicate that approximately 48.1% of medical staff exclusively breastfeed for more than six months, which exceeds the global average of 43%[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This suggests that medical staff generally possess a strong understanding of breastfeeding. They typically receive comprehensive medical education and training, equipping them with a thorough knowledge of the importance of breastfeeding. As a result, they are proficient in breastfeeding techniques, aware of its benefits, and capable of addressing challenges that may arise during breastfeeding. Furthermore, they often have access to various resources to seek assistance. These factors, including solid knowledge, a deep understanding of breastfeeding, and increased access to support, likely contribute to higher breastfeeding success rates and longer breastfeeding durations.\u003c/p\u003e \u003cp\u003eThis study indicates that, similar to common breastfeeding challenges, medical staff also encounter several difficulties during the breastfeeding process. Nipple and breast issues are the most prevalent, affecting up to 60% of medical staff. This suggests that, despite their professional knowledge, medical staff may still face technical challenges during breastfeeding and require additional practical guidance and support. It also highlights the need for breastfeeding consultation clinics. Work-related factors represent another significant challenge, affecting 50% of participants. This issue is primarily due to the negative impact of work pressures and schedules on breastfeeding, particularly after returning to work, when the working environment and conditions may hinder breastfeeding continuation. To improve breastfeeding success rates and durations, it is recommended to provide better lactation support facilities in the workplace, encourage medical staff to actively engage in prenatal breastfeeding counseling, and offer systematic breastfeeding education in the delivery ward. Additionally, technical training to address potential breastfeeding challenges should be provided in advance.\u003c/p\u003e \u003cp\u003eThe number of deliveries, breastfeeding clinic consultations during pregnancy, the work shift start time, and family support are independent factors influencing medical staff's ability to continue exclusive breastfeeding for six months. Mothers with multiple previous births possess greater experience and confidence in breastfeeding, which enables them to better manage related challenges, thus prolonging the duration of exclusive breastfeeding. A qualitative study found that confidence plays a key role in helping mothers persevere during difficult moments in their breastfeeding journey[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Additionally, there is a significant positive correlation between maternal confidence levels and both the extent and duration of breastfeeding[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe results of this study indicate that the earlier the return to work, the shorter the duration of exclusive breastfeeding. Mothers returning to work may experience stress related to balancing work and motherhood, which can inhibit the lactation reflex and lead to insufficient milk production[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A survey on domestic anesthetists (n\u0026thinsp;=\u0026thinsp;1364) found that 96.1% reported a decrease in lactation after returning to work[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Among the 1161 anesthesiologists who ceased breastfeeding, 836 (72.0%) failed to meet their breastfeeding goals due to professional factors. Furthermore, most mothers who return to work completely discontinue breastfeeding within a month [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Studies and others have shown that the exclusive breastfeeding rate is significantly higher among non-working women compared to working women[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. These studies suggest that the timing of return to work has a significant impact on the continuation of exclusive breastfeeding.\u003c/p\u003e \u003cp\u003eThe family support system is a key factor influencing the duration of breastfeeding. Our study demonstrates that family support plays a significant role in the duration of exclusive breastfeeding among healthcare workers. Previous study have also emphasized that family support is crucial for extending the duration of exclusive breastfeeding [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Similarly, research by Dib et al. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] indicated that enhanced family support can reduce the incidence of breastfeeding problems and prolong breastfeeding duration. Furthermore, Chang et al. [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]found that full support from family members is essential for promoting breastfeeding. Therefore, it is important to increase the dissemination of breastfeeding knowledge and improve the cognitive and practical capabilities of families, thereby increasing the rate and duration of exclusive breastfeeding.\u003c/p\u003e \u003cp\u003eThis study successfully developed a nomogram prediction model, with internal validation results demonstrating good discrimination and accuracy. In clinical practice, the nomogram should be used to assign scores to patients based on relevant factors, and the probability of successful breastfeeding should be evaluated according to the total score. This approach can guide early clinical interventions, facilitating the adoption of targeted measures to improve breastfeeding success rates and duration.\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, due to time and resource constraints, the sample size was relatively small. Second, random sampling was not employed, and some mothers who exclusively formula-fed declined to participate, potentially introducing selection bias. Additionally, data regarding the duration of exclusive breastfeeding among medical staff were based on maternal recall, which may introduce recall bias. Future research should involve a larger, more rigorously designed study with random sampling to better estimate the prevalence of exclusive breastfeeding. Currently, most studies on the factors influencing breastfeeding among medical staff are cross-sectional in nature. It is recommended that future research adopt cohort study designs to track these influencing factors more effectively.\u003c/p\u003e \u003cp\u003eIn summary, this study identified several factors influencing exclusive breastfeeding among medical staff, including the number of deliveries, breastfeeding consultation during pregnancy, the earliest work shift start time, and family support. To increase the prevalence of exclusive breastfeeding among medical staff, it is essential to enhance breastfeeding consultation services during pregnancy, optimize work arrangements, provide appropriate breastfeeding support facilities, and encourage family involvement in supporting breastfeeding. These measures can effectively extend breastfeeding duration, thereby promoting the health of both medical staff and their infants. Future research should further investigate the specific mechanisms underlying these factors and validate the findings on a larger scale to develop more effective interventions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eWHO \u0026nbsp; World Health Organization\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eUNICEF \u0026nbsp;United Nations Children\u0026apos;s Fund\u003c/p\u003e\n\u003cp\u003eSD \u0026nbsp; Standard Deviation\u003c/p\u003e\n\u003cp\u003eAUC \u0026nbsp; \u0026nbsp;Area Under Curve\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTingting Dai: led the article design, data collection and analysis, and wrote the first draft. Jiaxin Wan: assisted in questionnaire design, questionnaire sending and receiving and data collection, and participated in translation proofreading. Qiuyue Liu: reviewed the literature, participated in the revision and improvement of the first draft, and proofread the references. Cheng Chen: provided funding for resources, guided the research and paper writing, and was responsible for communicating with journals.Xiaoyan Liu: Expanded the sample scope, promoted the research results, optimized the language of the paper and assisted in the submission follow-up.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eChongqing Science and Technology Communication and Popularization Project\u0026nbsp;（cstc2023kpzx-kpzpBX0022),Chongqing Medical Leading Talent Project（YXLJ202416）\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data and materials supporting the findings in this study are available from \u0026nbsp;the corresponding author upon request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the Ethics Committee of Chongqing General Hospital (KY S2023-080-01). All participants provided informed consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConsent to publish is not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors are without conflicts of interest, including specific financial interests, relationships, and affiliations relevant to the subject of their manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePrentice AM: \u003cstrong\u003eBreastfeeding in the modern world\u003c/strong\u003e. \u003cem\u003eANN NUTR METAB\u003c/em\u003e 2022, \u003cstrong\u003e78\u003c/strong\u003e(Suppl. 2):29-38.\u003c/li\u003e\n\u003cli\u003eNorth K, Gao M, Allen G, Lee AC: \u003cstrong\u003eBreastfeeding in a global context: epidemiology, impact, and future directions\u003c/strong\u003e. \u003cem\u003eCLIN THER\u003c/em\u003e 2022, \u003cstrong\u003e44\u003c/strong\u003e(2):228-244.\u003c/li\u003e\n\u003cli\u003eHollis JL, Collins CE, DeClerck F, Chai LK, McColl K, Demaio AR: \u003cstrong\u003eDefining healthy and sustainable diets for infants, children and adolescents\u003c/strong\u003e. \u003cem\u003eGlobal Food Security\u003c/em\u003e 2020, \u003cstrong\u003e27\u003c/strong\u003e:100401.\u003c/li\u003e\n\u003cli\u003eTucker Z, O Malley C: \u003cstrong\u003eMental health benefits of breastfeeding: a literature review\u003c/strong\u003e. \u003cem\u003eCureus\u003c/em\u003e 2022, \u003cstrong\u003e14\u003c/strong\u003e(9).\u003c/li\u003e\n\u003cli\u003eYuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, Griffen A, McIntyre L, Byatt N, Moore Simas TA: \u003cstrong\u003eThe effects of breastfeeding on maternal mental health: a systematic review\u003c/strong\u003e. \u003cem\u003eJournal of women\u0026apos;s health\u003c/em\u003e 2022, \u003cstrong\u003e31\u003c/strong\u003e(6):787-807.\u003c/li\u003e\n\u003cli\u003eLiu K, Guo J, Deng W, Su Y: \u003cstrong\u003eThe Current Status of Breastfeeding Knowledge and Its Influencing Factors in Nursing Undergraduates: A Cross-Sectional Study in China\u003c/strong\u003e. \u003cem\u003eINT J ENV RES PUB HE\u003c/em\u003e 2022, \u003cstrong\u003e20\u003c/strong\u003e(1):103.\u003c/li\u003e\n\u003cli\u003eMulcahy H, Philpott LF, O\u0026apos;Driscoll M, Bradley R, Leahy-Warren P: \u003cstrong\u003eBreastfeeding skills training for health care professionals: A systematic review\u003c/strong\u003e. \u003cem\u003eHeliyon\u003c/em\u003e 2022, \u003cstrong\u003e8\u003c/strong\u003e(11).\u003c/li\u003e\n\u003cli\u003eGupta A, Suri S, Dadhich JP, Trejos M, Nalubanga B: \u003cstrong\u003eThe world breastfeeding trends initiative: implementation of the global strategy for infant and young child feeding in 84 countries\u003c/strong\u003e. \u003cem\u003eJ PUBLIC HEALTH POL\u003c/em\u003e 2019, \u003cstrong\u003e40\u003c/strong\u003e(1):35-65.\u003c/li\u003e\n\u003cli\u003eAlay\u0026oacute;n S, Varela V, Mukuria Ashe A, Alvey J, Milner E, Pedersen S, Yourkavitch J: \u003cstrong\u003eExclusive breastfeeding: Measurement to match the global recommendation\u003c/strong\u003e. \u003cem\u003eMaternal \u0026amp; child nutrition\u003c/em\u003e 2022, \u003cstrong\u003e18\u003c/strong\u003e(4):e13409.\u003c/li\u003e\n\u003cli\u003eHacking M, Jackson L, Fallon V, Harrold JA, Davie P, Silverio SA, Slade P: \u003cstrong\u003eAn interpretive phenomenological analysis of the experiences of mothers who continue to breastfeed despite facing difficulties\u003c/strong\u003e. \u003cem\u003eWOMEN BIRTH\u003c/em\u003e 2024, \u003cstrong\u003e37\u003c/strong\u003e(2):387-393.\u003c/li\u003e\n\u003cli\u003eMoraes GGWD, Christoffel MM, Toso BRGD, Viera CS: \u003cstrong\u003eAssociation between duration of exclusive breastfeeding and nursing mothers\u003c/strong\u003e\u003cstrong\u003e\u0026rsquo;\u003c/strong\u003e\u003cstrong\u003e self-efficacy for breastfeeding\u003c/strong\u003e. \u003cem\u003eREV ESC ENFERM USP\u003c/em\u003e 2021, \u003cstrong\u003e55\u003c/strong\u003e:e3702.\u003c/li\u003e\n\u003cli\u003eAhmad RS, Sulaiman Z, Nik Hussain NH, Mohd Noor N: \u003cstrong\u003eWorking mothers\u003c/strong\u003e\u003cstrong\u003e\u0026rsquo;\u003c/strong\u003e\u003cstrong\u003e breastfeeding experience: a phenomenology qualitative approach\u003c/strong\u003e. \u003cem\u003eBMC PREGNANCY CHILDB\u003c/em\u003e 2022, \u003cstrong\u003e22\u003c/strong\u003e(1):85.\u003c/li\u003e\n\u003cli\u003eXu X, Wang R, Zhang Y, Li J, Li H, Yu X, Zhang J, Li X, Huang Y: \u003cstrong\u003eOccupational factors associated with time to breastfeeding discontinuation after return to work among female anesthesiologists in China: a nationwide survey\u003c/strong\u003e. \u003cem\u003eAnesthesia \u0026amp; Analgesia\u003c/em\u003e 2024, \u003cstrong\u003e139\u003c/strong\u003e(1):135-143.\u003c/li\u003e\n\u003cli\u003eBlencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A, Narwal R, Adler A, Garcia CV, Rohde S, Say L: \u003cstrong\u003eNational, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications\u003c/strong\u003e. \u003cem\u003eThe lancet\u003c/em\u003e 2012, \u003cstrong\u003e379\u003c/strong\u003e(9832):2162-2172.\u003c/li\u003e\n\u003cli\u003eNgao OD, Mboineki JF: \u003cstrong\u003eComparative study of exclusive breastfeeding practice among employed mothers and housewives in Tanzania\u003c/strong\u003e. \u003cem\u003eJournal of Health, Population and Nutrition\u003c/em\u003e 2023, \u003cstrong\u003e42\u003c/strong\u003e(1):72.\u003c/li\u003e\n\u003cli\u003eBhandari MS, Manandhar P, Tamrakar D: \u003cstrong\u003ePractice of breastfeeding and its barriers among women working in tertiary level hospitals\u003c/strong\u003e. \u003cem\u003eJNMA: Journal of the Nepal Medical Association\u003c/em\u003e 2019, \u003cstrong\u003e57\u003c/strong\u003e(215):8.\u003c/li\u003e\n\u003cli\u003eXianlin W, Yuqi F, Tuanmei W, Zhuan Y, Lijuan X, Hongyan L, Fang P, Juan W: \u003cstrong\u003eAnalysis of the duration of exclusive breastfeeding in premature infants and its influencing factors\u003c/strong\u003e. \u003cem\u003eJournal of Pediatric Nursing\u003c/em\u003e 2023, \u003cstrong\u003e73\u003c/strong\u003e:e180-e186.\u003c/li\u003e\n\u003cli\u003eDib S, Fewtrell M, Wells JC, Shukri NHM: \u003cstrong\u003eThe influence of hospital practices and family support on breastfeeding duration, adverse events, and postnatal depression among first-time mothers\u003c/strong\u003e. \u003cem\u003eMalaysian Journal of Medicine and Health Sciences\u003c/em\u003e 2020, \u003cstrong\u003e16\u003c/strong\u003e(6):90-98.\u003c/li\u003e\n\u003cli\u003eChang Y, Li KMC, Li KYC, Beake S, Lok KYW, Bick D: \u003cstrong\u003eRelatively speaking? Partners\u0026apos; and family members\u003c/strong\u003e\u003cstrong\u003e\u0026rsquo;\u003c/strong\u003e\u003cstrong\u003e views and experiences of supporting breastfeeding: a systematic review of qualitative evidence\u003c/strong\u003e. \u003cem\u003ePhilosophical Transactions of the Royal Society B\u003c/em\u003e 2021, \u003cstrong\u003e376\u003c/strong\u003e(1827):20200033.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-breastfeeding-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ibfj","sideBox":"Learn more about [International Breastfeeding Journal](http://internationalbreastfeedingjournal.biomedcentral.com/)","snPcode":"13006","submissionUrl":"https://submission.nature.com/new-submission/13006/3","title":"International Breastfeeding Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Exclusive breastfeeding, Medical staff, Influencing factors, Successful breastfeeding, Prediction model","lastPublishedDoi":"10.21203/rs.3.rs-5730401/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5730401/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThis study aims to evaluate the breastfeeding practices among medical staff in southwest China, identify the influencing factors, and provide recommendations for improving the exclusive breastfeeding rate and prolonging the duration of exclusive breastfeeding among medical professionals.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional survey was conducted among 685 medical staff who gave birth and were weaned between January 2019 and January 2024. The questionnaire included sections on general demographics, breastfeeding knowledge, breastfeeding practices, and return-to-work timing. Univariate and multivariate logistic regression analyses were employed to identify factors influencing exclusive breastfeeding, and R software was used to construct and validate a nomogram prediction model based on the findings.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 685 participants, 363 (52.9%) exclusively breastfed for less than 6 months (Group A), while 322 (47.1%) breastfed exclusively for 6 months or longer (Group B). Univariate analysis revealed statistically significant differences between the two groups in terms of maternal income, number of deliveries, early initiation of breastfeeding within one hour post-delivery, access to breastfeeding consultation during pregnancy, earliest work shift start time, diet regularity during lactation, husband's support for breastfeeding, and family support for breastfeeding (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Multivariate logistic regression analysis identified the number of deliveries, breastfeeding consultation during pregnancy, earliest start time of work shift, and family support for breastfeeding as independent factors influencing the continuation of exclusive breastfeeding for 6 months (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The nomogram prediction model for successful breastfeeding showed an area under the ROC curve of 0.753 (95% CI, 0.702\u0026ndash;0.805), demonstrating good consistency between the predicted and observed outcomes, closely approximating the ideal curve.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eMedical institutions should actively establish breastfeeding consultation clinics, work to minimize maternal work hours, and promote breastfeeding education to raise societal awareness, which will help improve the exclusive breastfeeding rate for infants under 6 months of age.\u003c/p\u003e","manuscriptTitle":"Analysis of breastfeeding status and influencing factors among medical staff in southwestern China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-01 09:27:58","doi":"10.21203/rs.3.rs-5730401/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-02T15:34:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-29T19:10:19+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-23T00:03:58+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-01-17T18:00:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"338123159626167156085772612404907339777","date":"2025-01-11T08:56:39+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"51825043999830382172014642569002101540","date":"2025-01-09T22:18:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"78979138881310385486859573881157916155","date":"2025-01-07T15:06:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"314508414842750212024568533424456378799","date":"2025-01-07T02:43:37+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-05T02:15:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-12-30T22:56:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-12-30T14:38:17+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Breastfeeding Journal","date":"2024-12-29T14:16:35+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-breastfeeding-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ibfj","sideBox":"Learn more about [International Breastfeeding Journal](http://internationalbreastfeedingjournal.biomedcentral.com/)","snPcode":"13006","submissionUrl":"https://submission.nature.com/new-submission/13006/3","title":"International Breastfeeding Journal","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"34563430-8d1f-40ea-b1b1-1b517a5c9e43","owner":[],"postedDate":"January 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-28T16:00:48+00:00","versionOfRecord":{"articleIdentity":"rs-5730401","link":"https://doi.org/10.1186/s13006-025-00757-x","journal":{"identity":"international-breastfeeding-journal","isVorOnly":false,"title":"International Breastfeeding Journal"},"publishedOn":"2025-07-25 15:57:28","publishedOnDateReadable":"July 25th, 2025"},"versionCreatedAt":"2025-01-01 09:27:58","video":"","vorDoi":"10.1186/s13006-025-00757-x","vorDoiUrl":"https://doi.org/10.1186/s13006-025-00757-x","workflowStages":[]},"version":"v1","identity":"rs-5730401","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5730401","identity":"rs-5730401","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}