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Hospital Actions Affect Breastfeeding

Overview

Hospital practices in the first hours and days after birth make the difference in whether and how long babies are breastfed. The WHO/UNICEF Baby-Friendly Hospital Initiative is the global standard for hospital care to support breastfeeding, with the Ten Steps to Successful Breastfeeding at its core.

The percentage of US hospitals implementing a majority of the Ten Steps increased from about 29% in 2007 to nearly 54% in 2013. However, of approximately 3,300 maternity hospitals in the US, only 289 are designated Baby-Friendly. Hospitals influence how the nearly 4 million US babies born each year are fed. Further improvement in hospital practices could increase breastfeeding rates and contribute to better child health.

Hospitals can:

  • Implement the Ten Steps to Successful Breastfeeding and work towards achieving Baby-Friendly designation.
  • Use CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey customized reports to improve maternity care practices that support breastfeeding.
  • Work with doctors, nurses, lactation care providers, and organizations to create networks that provide clinic-based, at-home, or community breastfeeding support for mothers.

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Photo: Mother and child

80% of babies born in the US start out breastfeeding.

6 in 10 breastfeeding mothers stop breastfeeding earlier than they intend.

14% of US babies are born in hospitals designated Baby-Friendly.

 

Problem


Practices in many US hospitals do not fully support breastfeeding.

Some of the Ten Steps on which hospitals fell shortest in 2013 included:
  • Just 26% of hospitals had a model breastfeeding policy (Step 1).
  • Only 26% of hospitals did not routinely feed formula to healthy, breastfed infants when there was no medical reason to do so (Step 6).
  • Less than half (45%) of hospitals kept mothers and babies together throughout the entire hospital stay, which provides opportunities to breastfeed and helps mothers learn feeding cues (Step 7).
  • Just 32% of hospitals provided enough support for breastfeeding mothers when they left the hospital (Step 10).
Not enough babies are breastfeeding as recommended:
  • Only 22% of babies are exclusively breastfed for 6 months as recommended.
  • Only 29% are breastfed for 12 months as recommended.
  • Babies who are breastfed have reduced risks of ear and respiratory infections, asthma, sudden infant death syndrome (SIDS), diabetes, and obesity.

Graphic: Percentage of babies breastfeeding during the first year. Click to view larger image and text description.

View large image and text description

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Infographic

What Can Be Done


The Federal government is

  • Helping hospitals become designated as Baby-Friendly through funding and technical assistance.
  • Supporting state health departments to help hospitals improve maternity care practices.
  • Tracking hospital policies and practices that support breastfeeding using CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey to evaluate federal, state and local efforts.
  • Making breastfeeding counseling and supplies available to families with no out-of-pocket cost through a health insurance plan provision of the Affordable Care Act.

States and local government can

  • Adopt standards for hospitals to support breastfeeding.
  • Help hospitals implement the Ten Steps to Successful Breastfeeding.
  • Help hospitals connect mothers to community programs for support once they leave the hospital.

Hospitals can

  • Implement the Ten Steps to Successful Breastfeeding and work towards achieving
    Baby-Friendly designation.
  • Use CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey customized reports to improve maternity care practices that support breastfeeding.
  • Work with doctors, nurses, lactation care providers, and organizations to create networks that provide clinic-based, at-home, or community breastfeeding support for mothers.

Healthcare providers can

  • Help write hospital policies that support mothers and babies to breastfeed.
  • Counsel mothers on breastfeeding during prenatal visits.
  • Include lactation care providers and other breastfeeding experts on patient care teams.
  • Support breastfeeding in the hospital and at well-baby visits.

Mothers and their families can

  • Talk to their healthcare providers about breastfeeding plans, and ask about how to get help with breastfeeding.
  • Ask about breastfeeding support practices and Baby-Friendly designation when choosing a maternity hospital.
  • Join with other community members to encourage local hospitals to improve breastfeeding support and become Baby-Friendly.

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