The effect of maternity practices on exclusive breastfeeding rates in U.S. hospitals

Abstract

The Baby-friendly Hospital Initiative (BFHI) includes a set of 10 evidenced-based maternity practices that when used together have been shown to improve breastfeeding outcomes. In 2007, the Centers for Disease Control and Prevention launched the Maternity Practices in Infant Nutrition and Care (mPINC) survey to assess and monitor these and other evidenced-based maternity practices. The purpose of this study was to explore individual maternity practices measured in the 2013 mPINC survey, along with hospital demographic information, and their relationships with exclusive breastfeeding (EBF) rates, using a sample of United States (U.S.) hospitals. We obtained mPINC survey data from 69 BFHI hospitals and 654 non-BFHI hospitals in the U.S., and EBF rates from The Joint Commission, a leading hospital accreditation agency. On the basis of linear regression analysis, we found that most maternity practices studied were significantly associated with EBF rates (max adjusted R = 14.9%). We found a parsimonious model with an adjusted R of 47.3%. This study supports the need for a systematic approach in providing breastfeeding support as no one maternity care practice was able to explain the variability in EBF rates as well as a collection of maternity care practices.

In-Hospital Formula Feeding and Breastfeeding Duration

“…Timing of daily weights, rooming-in, early skin-to-skin contact, provision of pacifiers, and location of routine newborn procedures also influence the likelihood of IHFF. 1,43,44 Early skin-to-skin contact between the mother and infant improves breastfeeding in the first hour after birth and can help reduce formula supplementation by increasing the frequency of feedings throughout the hospital stay. Skin-to-skin care has been shown to be safe and leads to improved breastfeeding outcomes, including duration.…”

Maternity ward staff perceptions of exclusive breastfeeding in Finnish maternity hospitals: A cross-sectional study

“…BFHI hospitals provide maternity ward staff with clear instructions regarding breastfeeding support; as a result, maternity ward staff at these hospitals work differently from those at non-BFHI hospitals 6 . Depending on the study, implementation of the BFHI guide is either partially 7 or entirely 8 responsible for the recent increase in EBF rates. In particular, the advice provided by the BFHI guide during these first days contributes both to successful breastfeeding at home 9 and sustained, long-term EBF 10 .…”

Pasteurised donor human milk audit: What is happening in the neonatal critical care unit?

“…As human breast milk has been associated with long‐term health benefits, this underscores the need to identify predictors that can enable timely interventions in order to achieve better lactation rates in mothers of preterm infants, particularly in the non‐Caucasian population 7 . There are a number of reasons attributed to infants successfully remaining on MOM from birth through to discharge, which may include attitudinal characteristics and hospital practices 16–18 . However, further research is needed to identify the barriers and enablers to successful establishment and sustained expression of MOM in this vulnerable population.…”