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CDC Releases New Report on Hospitals’ Support of Breastfeeding

June 13, 2008

The CDC has released a new summary of findings with regards to how well U.S. hospitals and birth centers meet Healthy People 2010 goals for supporting breastfeeding.

First, a little background. Healthy People 2010 is a series of health improvement objectives for the nation, with goals of increasing life expectancy, improving quality of life, and eliminating health disparities. Specific targets to reach by 2010 have been established in areas such as tobacco use, maternal health, nutrition, oral health, overweight, mental health, injury and violence prevention, and the like. The breastfeeding objective is to increase early postpartum breastfeeding from 64% to 75%, breastfeeding at 6 months from 29% to 50%, and the one-year rate from 16% to 25%.

In 2007, a survey was distributed to hospitals and birth centers to assess how well they were addressing these targets. They were asked about practices related to 1) labor and delivery, 2) breastfeeding assistance, 3) mother-newborn contact, 4) newborn feeding practices, 5) breastfeeding support after discharge, 6) nurse/birth attendant breastfeeding training and education, and 7) structural and organizational factors related to breastfeeding.

2,687 facilities (2,546 hospitals and 121 birth centers) from 50 states, Puerto Rico, and D.C. returned the surveys, and were assigned scores from 1 to 100, with 100 being the most supportive of breastfeeding.

Among the findings:
Regional variation was apparent. Out of context, you’d probably think this was an election map. My southern sisters are being served least well with regards to breastfeeding support.
-99% of facilities had documented the feeding decisions of the majority of mothers in facility records
-88% “taught the majority of mothers techniques related to breastfeeding”
-“65% of facilities advised women to limit the duration of suckling at each breastfeeding, and 45% reported giving pacifiers to more than half of all healthy, full-term breastfed infants, practices that are not supportive of breastfeeding” (see report online for references for these statements).
70% of facilities reported providing discharge packs containing infant formula samples to breastfeeding mothers (another practice considered “not supportive of breastfeeding”)
-This is something I didn’t expect – “postpartum home visits were reported by 22% of facilities.” However, breastfeeding support after discharge received the lowest mean score of all measures.
-“24% of facilities reported giving supplements (and not breast milk exclusively) as a general practice with more than half of all healthy, full-term breastfeeding newborns”
-“In addition, 17% of facilities reported they gave something other than breast milk as a first feeding to more than half the healthy, full-term, breastfeeding newborns born in uncomplicated cesarean births.”

Findings from birth centers are also included – in general, they scored higher overall than hospitals (mean of 86 vs. 62 for hospitals).

The authors note that participating facilities will receive a benchmarking report in July of this year illustrating how they stack up against other facilities in their state, similarly sized facilities, and the nation.

[Cross-posted at Our Bodies Our Blog]

5 Comments leave one →
  1. June 13, 2008 12:58 pm

    I think the postpartum visits were probably lower-income women receiving visits from WIC, crisis nursery, first steps programs, or social workers.

  2. June 13, 2008 2:12 pm

    Kristina, I think you’re probably right – I’m on the board of an organization in Nashville that is over a Maternal Infant Health Outreach Worker program that does visits during and after pregnancy in low-income areas for a variety of support and education issues. I’m glad to see any of those types of visits are being done.

  3. June 13, 2008 6:10 pm

    Thank you for posting this, but HOW AWFUL!!

    I understand that it can be challenging to implement good breastfeeding support, but I can’t believe how many hospitals are still practicing things that are so detrimental to breastfeeding and that contravene the International Code of Marketing Breastmilk Substitutes.

    I blogged on this topic recently too:

  4. June 13, 2008 8:47 pm

    I know this probably makes up a small part of that 22%, but just for the record–some (most? all? not sure) freestanding birth centers provide postpartum home visits to all their clients (regardless of income) to check on mom & baby because they send them home a lot earlier than do hospitals. The center where I gave birth lets most families go home about six hours after the birth if they feel ready. A midwife then calls each day to check in, and a fantastic grandmotherly nurse visits on day 3 postpartum. It’s a lovely and useful system combining excellent support with the chance to bond with your baby in your own space, and I was quite spoiled by it.

  5. June 14, 2008 8:00 am

    Molly – thanks for chiming in – I assumed that was the case but the report doesn’t have enough info on that aspect.

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