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Total 10-Step Scores Stratified by Baby-Friendly Hospital Status and by Intention to Breastfeed (N = 182).
Source publication
Background
The Baby-Friendly Hospital Initiative is an effective intervention to support maternal practices around breastfeeding. However, adherence of hospitals to the Baby-Friendly 10 Steps, as determined from the perspective of women participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children, has n...
Context in source publication
Context 1
... BFH Score is shown separately for participants with medical exclusions versus those without a medical exclusion (i.e., eligible for the Step; Table 3). The BFH score was roughly one point higher in eligible participants compared to those with a medical exclusion, and this was also true for both participant-centered scores. ...Similar publications
Background:
The Iowa Infant Feeding Attitude Scale (IIFAS), which is used for the assessment of attitudes towards breastfeeding, has been found to be reliable and valid in a number of countries, but has not yet been psychometrically tested in Polish women. The purpose of the study was to report on the cultural adaptation of the IIFAS to Polish set...
Background
Confounding is a major threat to causal inferences regarding alcohol and health. One proposed causal inference approach was to compare the associations obtained from cohorts in different countries, where we know the confounding structures are different. To explore the confounding structure related to alcohol and health in Taiwan, we comp...
Breastfeeding is the best way to feed an infant, although it can also be a source of abiotic contaminants such as heavy metals or bisphenol A (BPA). The early life exposure to these compounds can lead to serious toxic effects in both the short and long-term. These substances can reach breast milk through the mother’s habits, diet being one of the m...
Breastfeeding is the first fundamental right of the child. Exclusive breastfeeding means giving a baby no other food or drink, not even water, in addition to breastfeeding Piyush (2007). In other to maintain the economic status and boost family income, women started to work in different sectors, which make it difficult for them to practice exclusiv...
Introduction
Globally, stunting is a significant public health concern and it is very critical in Ethiopia. This research aims to determine the prevalence of stunting and its correlates among children in the pastoral community.
Methods
A community-based cross-sectional study was conducted in Dubti District, Afar Region, North East Ethiopia from 2–...
Citations
... Aligned with these imperatives, WHO and the United Nations Children's Fund (UNICEF) underscore the significance of early initiation of BF and exclusive breastfeeding (EBF) for up to 6 months. This commitment has been reinforced through initiatives such as the Ten Steps to Successful Breastfeeding (TSSB) program, advocating for comprehensive breastfeeding practices within healthcare institutions (Ducharme-Smith et al., 2021;UNICEF, 2018;WHO, 2018). ...
Plain Language Summary
Breastfeeding, endorsed by religious, cultural, and scientific evidence, experiences divergent rates in Jordan due to substantial sociodemographic and cultural variations. Our aim is to explore the predictors and barriers that affect BF practices among mothers in Southern Jordan, in order to insight the healthcare providers to identify these barriers in order to increase awareness for the initiation and continuation of breastfeeding. A cross-sectional study was conducted among 380 mothers with infant two weeks to six months old. Data were analyzed using descriptive statistics and multinomial logistic regression. Findings revealed exclusive breastfeeding at 24%, mixed feeding at 57.63%, and artificial feeding at 18.42%. The study illuminated pronounced barriers in socio-environmental factors (1.65 ± 0.32), infant factors (1.63 ± 0.37), and maternal (1.59 ± 0.27). Predictors encompassed maternal age, education, employment, province, income, family member, delivery mode, and prior breastfeeding experience. In South Jordan, mixed feeding was the commonest way. Mothers’ work and lack of nursery at the workplace was the most noticeable factor. This study equips healthcare providers to recognize barriers hampering breastfeeding among Jordanian mothers, enabling informed strategies to enhance awareness and sustain breastfeeding initiation and continuation. Our study has several limitations. Firstly, its cross-sectional design relies on retrospective reporting of BF practices, potentially introducing bias. Additionally, despite employing random sampling of health centers, the generalizability of our findings is restricted by the use of convenience sampling.
... The WHO and UNICEF work with national authorities to administer the BFHI; in the US, this third party authority is Baby-Friendly USA (BFUSA) (BFUSAa, 2022). Baby-Friendly designation has been associated with improved likelihood of in-hospital EBF following birth and up to 2-6 weeks postpartum (Ducharme-Smith et al., 2021;Kivlighan et al., 2020;Feldman-Winter et al., 2017). Another analysis, which included 2014 US data, found that Baby-Friendly designation was associated with higher in-hospital EBF prevalence after controlling for hospital neighborhood sociodemographic factors such as race/ethnicity and education of residents (Patterson et al., 2018). ...
Objectives
To examine US in-hospital exclusive breastfeeding (EBF) and the associations with Baby-Friendly designation and neighborhood sociodemographic factors.
Methods
Hospital data from the 2018 Maternity Practices in Infant Nutrition and Care survey were linked to hospital zip code tabulation area (ZCTA) sociodemographic data from the 2014–2018 American Community Survey (n = 2,024). The percentages of residents in the hospital ZCTA were dichotomized based on the relative mean percentage of the hospital’s metropolitan area, which were exposure variables (high/low Black hospitals, high/low poverty hospitals, high/low educational attainment hospitals) along with Baby-Friendly designation. Using linear regression, we examined the associations and effect measure modification between Baby-Friendly designation and hospital sociodemographic factors with in-hospital EBF prevalence.
Results
US mean in-hospital EBF prevalence was 55.1%. Baby-Friendly designation was associated with 9.1% points higher in-hospital EBF prevalence compared to non-designated hospitals [95% confidence interval (CI): 7.0, 11.2]. High Black hospitals and high poverty hospitals were associated with lower EBF prevalence (difference= -3.3; 95% CI: -5.1, -1.4 and − 3.8; 95% CI: -5.7, -1.8). High educational attainment hospitals were associated with higher EBF prevalence (difference = 6.7; 95% CI: 4.1, 9.4). Baby-Friendly designation was associated with significant effect measure modification of the in-hospital EBF disparity attributed to neighborhood level poverty (4.0% points higher in high poverty/Baby-Friendly designated hospitals than high poverty/non-Baby-Friendly designated hospitals).
... Around the world, several initiatives aim to support and sustain breastfeeding. Among organizations at the hospital level, Baby-Friendly Initiatives (BFIs) have the strongest scientific basis, demonstrating its effectiveness [1][2][3][4]. Baby-Friendly Hospitals (BFHs) provide a three-step validation procedure to demonstrate commitment to competent breastfeeding support. At the level of healthcare professionals, the International-Board-Certified Lactation Consultants (IBCLC) certification represents the highest level of expertise in breastfeeding assessment and in the implementation of strategies to support difficult breastfeeding, and it represents the gold standard for improving breastfeeding skills [5,6]. ...
Despite the care provided, some newborns, who are perfectly healthy, show functional alterations that impair a good breast attack in the first few days. This situation often leads to the early failure of lactation. We conducted a randomized single-blind controlled trial to evaluate whether four weeks of osteopathic treatment can normalize the sucking score in a group of neonates with impaired lactation ability. Forty-two healthy full-term neonates were enrolled in this study. On the basis of the sucking score and the assessment of the infant’s breastfeeding skills, infants who had intrinsic breastfeeding difficulties were selected. The inclusion criteria were healthy infants born > 37 weeks, a suction score ≤ 6, and any breast milk at enrolment. At the end of the study, the sucking score was significantly greater in the osteopathic group than in the untreated group; the median sucking score in the treated group was in the normal range, while it remained lower in the untreated group. At the end of the follow-up, the percentage of exclusively breastfeeding infants in the treatment group increased by +25%. This pilot study demonstrates the efficacy of early osteopathic intervention to relieve breastfeeding difficulties in newborns in the first few weeks of life.
... Studies conducted in North and South Carolina and Maryland,USA as well as in Norwegian, Lebanon, and Korea counties reported that the a significant association between rates of exclusive breastfeeding and duration of exclusive breastfeeding with the presence of baby friendly workplace initiatives [17,[31][32][33][34]. The association between breast feeding and nutritional status was explained in the study done in Kenya.The study indicated that There was a significant association between delay in time of breastfeeding initiation and stunting, discontinuation of breastfeeding and underweight [35]. ...
Background
Baby-friendly workplace is an effective evidence based initiative developed by the World Health Organization to protect and support maternal knowledge, beliefs, and confidence in infant and young child feeding practices. However, studies that show the effect of the baby-friendly workplace initiative on the nutritional status of infant and young children are not available in Ethiopia. Therefore, this study aimed to assess the nutritional status among baby friendly initiatives service utlizers and non utlizers children age 6–24 months in public health facilities of Southern Ethiopia.
Methods
We conducted a comparative cross-sectional study from 1 to 30 June 2022 among 220 mothers with children aged 6–24 months. Data were collected through face-to-face interviews using a structured questionnaire. Data were entered into Epidata Software version 4.2 and then exported to IBM SPSS version 26 software for analysis. Chi-square and Fisher exact test were used to assess the differences between users and non-users of the baby friendly workplace initiative. Logistic regression model was used to determine the association between dependent and independent variables. Adjusted odds ratio (AOR) with a 95% confidence interval was computed. P-values < 0.05 at a 95% confidence level were considered statistically significant.
Result
The mean (SD) scores of weight for age (WAZ), height for age (HAZ), and weight for height (WHZ) were − 0.38 (1.34),-0.17(2.62) and-0.35 (1.84) respectively. After adjusting for covariates, children aged 6–24 months who did not use baby friendly workplace initiatives were 2.26 times more likely to have stunting compared to the users of baby friendly workplace initiative (AOR 2.26, 95% CI: 1.05, 4.88). However, both wasting (AOR: 0.42; 95% CI:0.13, 1.37) and underweight (AOR: 1.09; 95% CI: 0.45, 2.60) were not significantly associated with the use of baby friendly workplace initiatives.
Conclusion
The use of baby friendly work place initiatives was successful in improving nutritional status, specifically chronic malnutrition in children. Strengthening and scaling up the baby friendly work place initiative program has the potential to reduce chronic malnutrition in Ethiopia and other similar settings with high burden of malnutrition areas, by implementing it in public facilities.
... were less likely to get information about the importance of breastfeeding, less likely to room in and more likely to be given formula at hospital discharge; Hispanic-identified parents more likely to receive pacifiers or artificial nipples; and black parents were less likely to room in (Ducharme-Smith et al., 2021). African American patients in Munn et al.'s (2018) study reported that they did not receive breastfeeding help-even though their narratives reflected that breastfeeding support was important to success-and their hospital records indicated that they had 5 times greater odds of nonparticipation in best practices compared to white patients. ...
... Education: Formula was given to infants of parents with lower education more often (Ducharme-Smith et al., 2021;Sipsma et al., 2019), and those who were exclusively formula feeding on postpartum day 2 were more likely to have a high school diploma or less (Lewkowitz et al., 2019). Participants with more than 12 years of education had a higher prevalence of breastfeeding . ...
... Positioning help and assistance with breastfeeding within 1 h after birth was associated with increased EBF at 1 week for 20-24 year olds, but not 30+ year olds (Sipsma et al., 2017). How age was categorized likely made a difference in some analyses, as younger participants (<25 years old) were more likely to experience assistance with breastfeeding within 1 hour after birth in one study (Ducharme-Smith et al., 2021), yet 18-19 year olds had 40% lower odds of experiencing this in another (Sipsma et al., 2017). Kair et al. (2019) found that the strongest positive association between high breastfeeding support and EBF was for obese patients, but fewer than one-fifth received this level of support and support was inconsistent. ...
Aim
To synthesize the literature on breastfeeding outcomes associated with exposure to internationally recognized best practices, such as the Baby‐Friendly Hospital Initiative, for patients in the United States during the postpartum period, contextualized within the Missed Care Model.
Design
The authors employed Whittemore and Knafl's integrative review framework and the 2020 PRISMA guidelines for data extraction, synthesis, reporting and assessment.
Methods
Five electronic databases were searched for articles published between 2007 and 2023. Eligible articles reported on exposure to breastfeeding best practices and outcomes or the experiences, views, perceptions and attitudes of parents, nurses or lactation consultants regarding hospital breastfeeding support. Extracted data were compared to identify in‐hospital exposure to breastfeeding best practices and breastfeeding outcomes, and differences in exposure and outcomes based on patient and provider characteristics.
Results
Twenty‐one quantitative, qualitative and mixed methods articles met inclusion criteria. A higher reported adherence to best practices was associated with greater odds of breastfeeding; some practices demonstrated greater effects overall or for specific groups. Higher exposures to best practices and higher breastfeeding rates were found for non‐Hispanic white patients, and those with more education, private insurance and who live in urban areas. Disparities in support and outcomes were related to patients' race/ethnicity, language, weight and age. Qualitative findings reflected missed care concepts, such as internal processes related to habits and group norms, relevant to breastfeeding support.
Conclusion
Review findings also include an adapted Missed Care Model specific to breastfeeding support, which can inform future research related to providers' internal processes that may influence breastfeeding or equitable breastfeeding care.
Implications for the Profession and/or Patient Care
Missed care can be influenced by a variety of factors, including providers' internal values and beliefs. Study findings suggest the existence of inequities in breastfeeding care and underscore the need to address and eliminate breastfeeding disparities.
Impact
This study addressed how patient exposure to best practices in breastfeeding support relates to breastfeeding outcomes and whether exposure and outcomes differ by patient or provider characteristics, connecting this to the Missed Care in Breastfeeding Support Model. The main findings were that higher reported exposure to best practices in breastfeeding support related to improved breastfeeding outcomes; inequities exist in exposure to best practices; and patients and providers identify the importance of providers' internal processes in the delivery of breastfeeding support, which aligns with the Missed Care in Breastfeeding Support Model. Study findings will have the potential to impact how nurses, lactation consultants and other providers who deliver breastfeeding support in the postpartum hospital setting.
Reporting Method
The authors adhered to relevant 2020 PRISMA reporting guidelines.
Patient or Public Contribution
No patient or public contribution.
... Penyedia layanan kesehatan dan tenaga kesehatan sangat berperan dalam penerapan program 10 LMKM. 30 Walaupun dalam hasil model akhir menunjukkan faktor usia, pendidikan, pekerjaan, tingkat pengetahuan tidak masuk ke dalam model, namun hasil uji chi-square menunjukkan faktor-faktor tersebut berhubungan dengan keberhasilan IMD pada ibu post partum. ...
Latar belakang: Penurunan cakupan ASI Eksklusif sebesar 32% pada tahun 2018 perlu mendapat perhatian. Praktik Inisiasi Menyusui Dini (IMD) perlu ditingkatkan karena berhubungan dengan keberhasilan pemberian ASI eksklusif dan dapat mencegah kematian bayi sebesar 22%. Angka IMD di Kota Tangerang tahun 2020 sebesar 30, 6% dibawah dari angka nasional tahun 2018 (58, 2%).
Tujuan: Penelitian ini bertujuan untuk menganalisis faktor yang berhubungan dengan perilaku Inisiasi Menyusu Dini (IMD) pada ibu nifas di Kota Tangerang.
Metode: Penelitian dilakukan menggunakan desain studi potong lintang dengan pendekatan analitik kuantitatif. Sebanyak 884 ibu post-partum menjadi responden penelitian yang diambil menggunakan teknik purposive sampling. Data dianalisis menggunakan chi square.
Hasil: Faktor usia ibu yang berada dalam rentang usia ideal, pendidikan, pekerjaan, riwayat terkena COVID 19, pengetahuan, dukungan tenaga kesehatan dan pelayanan kesehatan merupakan faktor yang berhubungan secara signifikan. Uji regresi logistik menunjukan faktor dominan yang berhubungan dengan perilaku IMD adalah faktor dukungan tenaga kesehatan (p-value= 0,013, Exp (B)= 25, 73 CI: 1,996—332,245). Kesimpulan: Dukungan tenaga kesehatan sebagai faktor dominan dalam perilaku IMD perlu mendapatkan perhatian dari pemangku kebijakan. Tenaga kesehatan dan pelayanan perlu ditingkatkan kapasitasnya agar dapat berperan optimal dalam peningkatan kesadaran ibu nifas untuk melakukan IMD dalam 6 jam pertama kelahiran.
... There was also variation in Iran [90] and Canada [102]. A USA study [103] reported adherence to the 10 Steps ranging from 10 to 85% (lowest for Step 9, highest for Step 10), with low adherence also to step 6 (do not provide breastfed newborns any food or fluids other than breast milk, unless medically indicated). ...
... More cost-effectiveness studies are also required, as highlighted in a recent study [148]. Ducharme-Smith et al. [103] highlighted that there is still a need for studies using larger samples to robustly test for differences in practices associated with BFHI and to examine implementation of all steps among different groups of women. The lack of long-term documentation, longitudinal studies or a historical data series of external evaluations was noted in several articles [149][150][151]. ...
Background
Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children’s Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally.
Methods
This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken.
Results
A total of 278 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and postpartum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies.
Conclusion
At a national level, political support for BFHI implementation supports expansion of Baby-Friendly Hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby Friendly Hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.
... 13 Our analysis provides more information about potential modifiable barriers for breastfeeding (eg, prepregnancy BMI, access to prenatal care, and smoking cessation) in a low-risk population and a way to identify individuals at risk of exclusive formula feeding, and create individual or group education programs or services that may help increase breastfeeding rate in that population. 33,[52][53][54] ...
Background
Better understanding of the factors associated with formula feeding during the hospital stay can help in identifying potential lactation problems and promote early intervention. Our aim was to ascertain factors associated with exclusive formula feeding in newborns of low‐risk pregnancies.
Methods
A population‐based, retrospective study using the United States vital statistics datasets (2014‐2018) evaluating low‐risk pregnancies with a nonanomalous singleton delivery from 37 to 41 weeks. People with hypertensive disorders, or diabetes, were excluded. Primary outcome was newborn feeding (breast vs exclusive formula feeding) during hospital stay. Adjusted relative risks (aRRs) with 95% confidence intervals (CI) were calculated.
Results
Of the 19 623 195 live births during the study period, 11 605 242 (59.1%) met inclusion criteria and among them, 1 929 526 (16.6%) were formula fed. Factors associated with formula feeding included: age < 20 years (aRR 1.31 [95% CI 1.31‐1.32]), non‐Hispanic Black (1.42, 1.41‐1.42), high school education (1.69, 1.69‐1.70) or less than high school education (1.94, 1.93, 1.95), Medicaid insurance (1.52, 1.51, 1.52), body mass index (BMI) < 18.5 (1.10, 1.09‐1.10), BMI 25‐29.9 (1.09, 1.09‐1.09), BMI 30‐34.9 (1.19, 1.19‐1.20), BMI 35‐39.9 (1.31, 1.30‐1.31), BMI ≥ 40 (1.43, 1.42‐1.44), multiparity (1.29, 1.29‐1.30), lack of prenatal care (1.49, 1.48‐1.50), smoking (1.75, 1.74‐1.75), and gestational age (ranged from 37 weeks [1.44, 1.43‐1.45] to 40 weeks [1.11, 1.11‐1.12]).
Conclusions
Using a large cohort of low‐risk pregnancies, we identified several modifiable factors associated with newborn feeding (eg, prepregnancy BMI, access to prenatal care, and smoking cessation). Improving the breast feeding initiation rate should be a priority in our current practice to ensure equitable care for all neonates.
... There was also variation in Iran [88] and Canada [101]. A USA study [102] reported adherence to the 10 Steps ranging from 10-85% (lowest for Step 9, highest for Step 10), with low adherence also to step 6 (do not provide breastfed newborns any food or uids other than breast milk, unless medically indicated). ...
Background
Improved breastfeeding practices have the potential to save the lives of over 823,000 children under 5 years old globally every year. The Baby-Friendly Hospital Initiative (BFHI) is a global campaign by the World Health Organization and the United Nations Children's Fund, which promotes best practice to support breastfeeding in maternity services. The Baby-Friendly Community Initiative (BFCI) grew out of step 10, with a focus on community-based implementation. The aim of this scoping review is to map and examine the evidence relating to the implementation of BFHI and BFCI globally.
Methods
This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Inclusion criteria followed the Population, Concepts, Contexts approach. All articles were screened by two reviewers, using Covidence software. Data were charted according to: country, study design, setting, study population, BFHI steps, study aim and objectives, description of intervention, summary of results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken.
Results
A total of 279 articles were included in the review. Patterns identified were: i) national policy and health systems: effective and visible national leadership is needed, demonstrated with legislation, funding and policy; ii) hospital policy is crucial, especially in becoming breastfeeding friendly and neonatal care settings iii) implementation of specific steps; iv) the BFCI is implemented in only a few countries and government resources are needed to scale it; v) health worker breastfeeding knowledge and training needs strengthening to ensure long term changes in practice; vi) educational programmes for pregnant and post-partum women are essential for sustained exclusive breastfeeding. Evidence gaps include study design issues and need to improve the quality of breastfeeding data and to perform prevalence and longitudinal studies.
Conclusion
At a national level, political support for BFHI implementation supports expansion of Baby friendly hospitals. Ongoing quality assurance is essential, as is systematic (re)assessment of BFHI designated hospitals. Baby friendly hospitals should provide breastfeeding support that favours long-term healthcare relationships across the perinatal period. These results can help to support and further enable the effective implementation of BFHI and BFCI globally.
... However, the association with EBF was attenuated with wide 95% CIs at 3 and 5 mo, when breastmilk is still recommended as the only source of nourishment. Somewhat in line with this finding, previous studies have reported mixed or null results regarding the association between rooming-in and any BF or EBF beyond the hospital stay [18,21,40,41], with some authors noting that this relationship may be confounded by the experience of early BF problems [18]. Notably, a survival analysis of national data found that the combination of lacking both rooming-in and feeding on cue was associated with an over 5-wk reduction in BF duration [41]. ...
... The unregulated marketing of breastmilk substitutes by infant formula manufacturers, in particular through the provision of free or low-cost samples and promotional materials to healthcare facilities, remains an important barrier to providing BF-friendly maternity care in the United States [43,44] and globally [45]. In agreement with previous studies conducted in more localized samples of WIC participants [20][21][22], we confirmed a negative association between receiving free infant formula (or related gifts) at the hospital and later BF in the national WIC-served population. In terms of EBF, previous research has shown provision of pro-formula gifts at discharge was associated with 45% to 74% lower odds of EBF at 6 mo of age [21,22]. ...
... In agreement with previous studies conducted in more localized samples of WIC participants [20][21][22], we confirmed a negative association between receiving free infant formula (or related gifts) at the hospital and later BF in the national WIC-served population. In terms of EBF, previous research has shown provision of pro-formula gifts at discharge was associated with 45% to 74% lower odds of EBF at 6 mo of age [21,22]. Although we did not confirm an association between receiving pro-formula gifts and EBF at 5 mo, our analysis differed from these studies in that it aimed to compare BF exclusivity among BF mothers only; thus, our results may help contextualize previous work and suggest that providing formula gifts at the hospital may influence rates of EBF at 5 or 6 mo through early BF cessation. ...
Background:
Breastfeeding (BF) provides optimal nutrition during the first 6 mo of life and is associated with reduced infant mortality and several health benefits for children and mothers. However, not all infants in the United States are breastfed, and sociodemographic disparities exist in BF rates. Experiencing more BF-friendly maternity care practices at the hospital is associated with better BF outcomes, but limited research has examined this association among mothers enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a population at risk of low BF rates.
Objectives:
We assessed the association between BF-related hospital practices (rooming-in, support from hospital staff, and provision of a pro-formula gift pack) and the odds of any or exclusive BF through 5 mo among infants and mothers enrolled in WIC.
Methods:
We analyzed data from the WIC Infant and Toddler Feeding Practices Study II, a nationally representative cohort of children and caregivers enrolled in WIC. Exposures included maternal experience of hospital practices reported at 1 mo postpartum, and BF outcomes were surveyed at 1, 3, and 5 mo. ORs and 95% CIs were obtained using survey-weighted logistic regression, adjusting for covariates.
Results:
Rooming-in and strong hospital staff support were associated with higher odds of any BF at 1, 3, and 5 mo postpartum. Provision of a pro-formula gift pack was negatively associated with any BF at all time points and with exclusive BF at 1 mo. Each additional BF-friendly hospital practice experienced was associated with 47% to 85% higher odds of any BF over the first 5 mo and 31% to 36% higher odds of exclusive BF over the first 3 mo.
Conclusions:
Exposure to BF-friendly hospital practices was associated with BF beyond the hospital stay. Expanding BF-friendly policies at the hospital could increase BF rates in the United States WIC-served population.
