Breastfeeding rates in US Baby-Friendly Hospitals: Results of a national survey

Department of Pediatrics, Boston University, Boston, Massachusetts, United States
PEDIATRICS (Impact Factor: 5.47). 10/2005; 116(3):628-34. DOI: 10.1542/peds.2004-1636
Source: PubMed


The objectives of this study were to analyze all available breastfeeding data from US Baby-Friendly hospitals in 2001 to determine whether breastfeeding rates at Baby-Friendly designated hospitals differed from average US national, regional, and state rates in the same year and to determine prime barriers to implementation of the Baby-Friendly Hospital Initiative.
In 2001, 32 US hospitals had Baby-Friendly designation. Using a cross-sectional design with focused interviews, this study surveyed all 29 hospitals that retained that designation in 2003. Demographic data, breastfeeding rates, and information on barriers to becoming Baby-Friendly were also collected. Simple linear regression was used to assess factors associated with breastfeeding initiation.
Twenty-eight of 29 hospitals provided breastfeeding initiation rates: 2 from birth certificate data and 26 from the medical record. Sixteen provided in-hospital, exclusive breastfeeding rates. The mean breastfeeding initiation rate for the 28 Baby-Friendly hospitals in 2001 was 83.8%, compared with a US breastfeeding initiation rate of 69.5% in 2001. The mean rate of exclusive breastfeeding during the hospital stay (16 of 29 hospitals) was 78.4%, compared with a national mean of 46.3%. In simple linear regression analysis, breastfeeding rates were not associated with number of births per institution or with the proportion of black or low-income patients. Of the Ten Steps to Successful Breastfeeding the 3 described as most difficult to meet were Steps 6, 2, and 7. The reason cited for the problem with meeting Step 6 was the requirement that the hospital pay for infant formula.
Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity. Elevated rates persist regardless of demographic factors that are traditionally linked with low breastfeeding rates.

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    • "By 6 months, only 33% of mothers are still breastfeeding, and 17% are breastfeeding exclusively. Efforts to increase breastfeeding rates in low-income women and women of color have been less successful (American Academy of Pediatrics; Merewood et al. 2005). Implementation of WHO's Baby Friendly Hospital Initiative has been shown to be associated with increased rates of breastfeeding initiation and exclusivity in the United States, even in demographic groups with traditionally low breastfeeding rates (Merewood et al.). "
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    ABSTRACT: This study investigates cultural differences in mothers' views regarding infant feeding and socialization. The majority of mothers reported breastfeeding as one of their methods of infant feeding, although more than half reported using both breast and bottle. Mothers in China expressed concerns that breastfeeding is not compatible with work outside of the home. American mothers were more likely to believe that breastfeeding is difficult to establish. "Happiness" was ranked the most important socialization goal by both groups. Public health initiatives must be culturally relevant and reflect an understanding of parenting values and beliefs.
    Ecology of Food and Nutrition 09/2009; 48(5):345-68. DOI:10.1080/03670240903170475 · 0.81 Impact Factor
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    • "In 1997, the United Nations Children's Fund (UNICEF) launched the Baby-Friendly Hospital initiative to promote adoption of 'Ten Steps to Successful Breastfeeding' in hospitals which were developed for maternity facilities (WHO/UNICEF 1989). It has been reported that in the United States the Baby- Friendly designated hospital has elevated rates of breastfeeding initiation and exclusivity (Merewood et al. 2005). Recently, Kruse and colleagues (2005) reported that hospital policies and practices influence rates of exclusive breastfeeding at discharge, and Taveras and colleagues (2004) reported that specific practices and opinions of paediatricians and nurse practitioners influenced continuation of exclusive breastfeeding . "
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    Child Care Health and Development 12/2008; 35(1):106-11. DOI:10.1111/j.1365-2214.2008.00899.x · 1.69 Impact Factor
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    ABSTRACT: Objetivo: comparar dos poblaciones respecto a la duración de la lactancia materna y determinar los factores limitantes de la misma. Material y métodos: estudio analítico transversal, realizado mediante un cuestionario a cumplimentar por los acompañantes de los niños que acudieron a la consulta del pediatra de Atención Primaria en los Centros de Salud de Montequinto en Sevilla y de Lumiar en Lisboa, durante el período de tiempo comprendido entre el 1 de noviembre y el 31 de diciembre de 2004. Resultados: se completaron 205 cuestionarios en Montequinto y 90 en Lumiar. La edad materna al nacimiento del primer hijo fue, como media, dos años mayor en la muestra de Montequinto. La duración media de la lactancia materna fue de 5,6 meses en Montequinto versus 3,2 meses en Lumiar, observándose en ambas una mayor duración en el segundo hijo. En Lumiar, las madres desempleadas son las que más tiempo han amamantado. La principal razón invocada en los dos grupos para la introducción de leche artificial fue la creencia de no disponer de leche suficiente. La introducción de la alimentación complementaria fue más tardía en Montequinto. Las principales fuentes de información sobre la lactancia en Montequinto fueron el pediatra de Atención Primaria o la enfermera. En Lumiar no fue así. Conclusiones: las diferencias encontradas podrían no ser representativas de la situación de la lactancia materna en ambos países, pero sí traducir una mayor atención a la promoción del amamantamiento por parte de los profesionales de Atención Primaria (pediatras y enfermeras) de Montequinto.
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