Hospital support for breastfeeding mothers has nearly doubled nationwide through a global initiative, but more work is needed to increase the number of baby-friendly hospitals, according to an Oct. 6 Vital Signs report released by the Centers for Disease Control and Prevention.
The report found the rate of U.S. hospitals using the World Health Organization’s Ten Steps to Successful Breastfeeding rose from 29% in 2007 to 54% in 2013.
©Jupiterimages/thinkstockphotos.com
“What happens in the hospital can determine whether a mom starts and continues to breastfeed, and we know that many moms – 60% – stop breastfeeding earlier than they’d like,” said CDC epidemiologist Cria Perrine, PhD, in a statement. “These improvements in hospital support for breastfeeding are promising, but we also want to see more hospitals fully supporting mothers who want to breastfeed. The Ten Steps help ensure that mothers get the best start with breastfeeding.”
Of the nearly 4 million babies born each year in the United States, 14% are born in “baby-friendly” hospitals, a number that has almost tripled in recent years, but remains low, according to the CDC. The Baby-Friendly Hospital Initiative was established by the World Health Organization and UNICEF and is endorsed by the American Academy of Pediatrics. The core of the initiative is the Ten Steps to Successful Breastfeeding, which measures a hospital’s breastfeeding support before, during, and after a mother’s hospital stay.
The report, “Vital Signs: Improvements in Maternity Care Policies and Practices That Support Breastfeeding — United States, 2007–2013,” examined data from CDC’s national survey, Maternity Practices in Infant Nutrition and Care, which measures the percentage of U.S. hospitals with practices that are consistent with the Ten Steps to Successful Breastfeeding. Findings showed that in 2013, 93% of hospitals provided high levels of: prenatal breastfeeding education, up from 91% in 2007. A majority of hospitals also taught mothers breastfeeding techniques – 92% in 2013 compared with 88% in 2007. Sixty-five percent of hospitals promoted early initiation of breastfeeding for mothers, up from 44% in 2007.
However, CDC leaders note that other findings demonstrate the need for improvement. For example, just over a quarter of hospitals surveyed had a model breastfeeding policy, commonly the foundation for many of the steps. Additionally, just 26% of hospitals ensured that only breast milk was given to healthy, breastfeeding infants who did not need infant formula for a medical reason in 2013. Only 45% of hospitals in 2013 kept mothers and babies together through their entire hospital stay, a practice which provides opportunities to breastfeed and helps mothers learn feeding cues, the report found. Just 32% of hospitals provided enough support for breastfeeding mothers when they left the hospital, including follow-up visits, phone calls, and referrals for additional support. These percentages were only slight increases from 2007, said CDC Director Dr. Tom Frieden during an Oct. 6 press conference.
“Every 1 of the 10 steps is important to use in the hospital to give babies the best start [and] to help mothers start and continue to breastfeed as recommended,” Dr. Frieden said. “I’d like to ask hospitals to keep making progress. Make a plan for what you can do right now that’s in line with the 10 steps, and phase that in over time. Ideally, we’d like every birth hospital in this country to adopt all of the 10 steps and become baby-friendly.”
Dr. Perrine acknowledged that hospitals are not without challenges in implementing the Ten Steps. Primary obstacles could be convincing hospital leadership to focus on the initiative, training staff, and confronting push-back from senior labor and delivery employees, Dr. Perrine said.
The CDC calls for more hospitals to implement the Ten Steps to Successful Breastfeeding and to work toward achieving baby-friendly status. Hospitals can also participate in CDC’s Maternity Practices in Infant Nutrition and Care survey and get an individualized report that shows how they compare with other hospitals. Additionally, hospitals should work with physicians, nurses, lactation care providers, and other organizations to develop networks that can provide clinic-based, at-home, or community breastfeeding support.
“Doctors can make a really big difference in encouraging and supporting women who choose to breastfeed,” Dr. Frieden said during the press conference. “And hospitals can play a critical role in those first few days of life which really do form the basis of the pattern of breastfeeding.”
On Twitter @legal_med