Data to Action Success Story: New York City

New York City: Making Breastfeeding the Norm in NYC

Problem Overview

The New York City Department of Health and Mental Hygiene (DOHMH) set forth an objective to make breastfeeding the norm in NYC by working at individual, community, institutional, and policy levels. Take Care New York, launched in 2004, aims to help New Yorkers live longer and healthier lives. “Take Care New York 2008” included a breastfeeding objective to improve maternal and infant health by encouraging healthy breastfeeding for infants. “Take Care New York 2012” took the 2008 objective a step further with the creation of Priority Area #9, which focused on healthy children, and set a target to increase the number of women who exclusively breastfeed their infants for at least 2 months to 45%.¹ DOHMN plans to support policies that encourage exclusive breastfeeding for at least 6 months.

Program Activity Description

In 2006, NYC collaborated with the New York City Health and Hospitals Corporation (HHC) to implement the Breast Milk Friendly Hospital Initiative (BMFHI), based on the WHO/UNICEF Baby Friendly Hospital Initiative (BFHI). The BMFHI is a collaborative effort between NYC and 11 public hospitals that include the training of all nurse, physician, and mid-level health providers in the BFHI principles. Principles include initiating breastfeeding within 1 hour of life, promoting rooming-in, eliminating formula company incentives, and encouraging only breast milk unless medically indicated. NYC PRAMS data from 2007, which were used to guide the program, showed that public hospitals had high prevalence rates of breastfeeding initiation (86%), but low rates of breastfeeding continuation and exclusivity (32% exclusive breastfeeding at 2 months).

Further, in 2009, NYC PRAMS breastfeeding data were used to guide aspects of a Public Health Detailing Kit on breastfeeding. The Public Health Detailing Program works with primary health care providers to improve patient care around key public health challenges. As part of the program, DOHMH representatives deliver brief, targeted messages to doctors, physician assistants, nurse practitioners, nurses, and administrators at their practice sites. The Detailing Kits, which contain clinical tools, resources for providers, and patient education materials, are distributed during site visits. In addition, PRAMS data about why mothers stop breastfeeding was used in developing educational materials for providers, as well as a Breastfeeding Guide for mothers.

Program Activity Outcomes

Preliminary data indicate that these programs are on their way in the mission to make breastfeeding the norm in NYC and have been successful in increasing breastfeeding initiation in the hospitals city wide from 54% to 80%, and exclusive breastfeeding in the hospitals from 15% to 29%, from 2004–2008.

In 2008, NYC implemented a similar initiative in Staten Island. NYC PRAMS data showed lower rates of breastfeeding initiation, continuation, and exclusivity in Staten Island as compared with other boroughs. This information was used to secure a $75,000 grant from the United Hospital Fund for each hospital in Staten Island to promote breastfeeding-friendly hospital practices, and Staten Island University Hospital received a Certificate of Intent to become a Baby-Friendly Hospital.

¹ Summers C, Cohen L, Havusha A, Slinger F, Farley T. Take Care New York 2012: A Policy for a Healthier New York City. New York Department of Health and Mental Hygiene, 2009 . Accessed July 28, 2011.