Less than 4% of U.S. hospitals provide the full range of supportive measures mothers need to be able to breastfeed, which can help protect against childhood obesity, a recent Vital Signs report said. In the US, 1 preschooler in 5 is at least overweight, and half of these are obese. A baby?s risk of becoming an overweight child goes down with each month of breastfeeding. In the US, most babies start breastfeeding, but within the first week, half have already been given formula, and by 9 months, only 31% of babies are breastfeeding at all. Hospitals can either help or hinder mothers and babies as they begin to breastfeed. The Baby-Friendly Hospital Initiative describes Ten Steps to Successful Breastfeeding that have been shown to increase breastfeeding rates by providing support to mothers. Unfortunately, most US hospitals do not fully support breastfeeding; they should do more to make sure mothers can start and continue breastfeeding.
?Hospitals play a vital role in supporting a mother to be able to breastfeed,? said CDC Director Thomas R.Frieden, M.D., M.P.H. ?Those first few hours and days that a mom and her baby spend learning to breastfeed are critical. Hospitals need to better support breastfeeding, as this is one of the most important things a mother can do for her newborn. Breastfeeding helps babies grow up healthy and reduces health care costs.?
The report examined data from CDC?s national survey of Maternity Practices in Infant Nutrition and Care (mPINC) and finds that only 14 percent of hospitals have a written, model breastfeeding policy. The report also finds that in nearly 80% of hospitals, healthy breastfeeding infants are given formula when it is not medically necessary, a practice that makes it much harder for mothers and babies to learn how to continue breastfeeding at home.
Additionally, only one-third of hospitals practice rooming in, which helps mothers and babies learn to breastfeed by allowing frequent chances to breastfeed. Finally, the report finds that in nearly 75% of hospitals, mothers and babies do not get the support they need when they leave the hospital, including a follow up visit, a phone call from hospital staff and referrals to lactation consultants and other important support systems in their community.
CDC?s mPINC survey measures the percent of U.S. hospitals with practices that are consistent with the WHO/UNICEF Ten Steps to Successful Breastfeeding. This list of proven hospital practices that increase rates of breastfeeding by providing support to mothers is the core of the Baby-Friendly Hospital Initiative and is endorsed by the American Academy of Pediatrics. The steps include:
Encouraging mothers to room in, staying with their baby 24 hours a day;
Connecting mothers with support groups and other resources to help with breastfeeding after they leave the hospital.
A hospital can be designated as Baby-Friendly when it has made special efforts to support mothers to start and continue breastfeeding and when it demonstrates that it follows all of the Ten Steps to Successful Breastfeeding.
?In the United States most women want to breastfeed, and most women start,? said Ursula Bauer, Ph.D., M.P.H., director of CDC's National Center for Chronic Disease Prevention and Health Promotion. ?But without hospital support many women have a hard time continuing to breastfeed, and they stop early. It is critical that hospitals take action to fully support breastfeeding mothers and babies so they can continue to breastfeed long after their hospital stay.?
Low rates of breastfeeding add $ 2.2 billion a year to medical costs. Babies who are fed formula and stop breastfeeding early have higher rates of obesity, diabetes, and respiratory and ear infections, and tend to require more doctor visits, hospitalizations and prescriptions. Changing hospital practices to better support mothers and babies can improve these rates. Some actions hospitals can take include:
Partnering with Baby-Friendly hospitals to learn how to improve maternity care;
Using CDC?s mPINC survey data to prioritize changes to improve maternity care practices;
Stopping distribution of formula samples and give-aways to breastfeeding mothers.
This issue of Vital Signs coincides with World Breastfeeding Week, which is celebrated every year from August 1-7 in more than 170 countries worldwide. World Breastfeeding Week serves as an awareness campaign that highlights and recognizes the benefits of breastfeeding in communities across the globe.
To improve maternity care practices and better support breastfeeding doctors and nurses can:
Learn how to counsel mothers on breastfeeding during prenatal visits, and support breastfeeding in the hospital and at each pediatric doctor?s visit until breastfeeding stops.
Include lactation consultants and other breastfeeding experts on patient care teams.
Coordinate lactation care between the hospital and outpatient clinic.
Federal government can:
Track hospital policies and practices that support mothers to be able to breastfeed.
Help all federal hospitals implement the Ten Steps to Successful Breastfeeding.
State and local government can:
Help hospitals use the Ten Steps to Successful Breastfeeding, starting with the largest hospitals in the state.
Mothers and their families can:
Ask about breastfeeding support practices when choosing a hospital.
Join with other community members to encourage local hospitals to become Baby-Friendly.
For more information about CDC?s efforts to improve hospital practices to support breastfeeding, visit http://www.cdc.gov/breastfeeding. For more information about state breastfeeding rates and activities to support breastfeeding, visit http://www.cdc.gov/breastfeeding/data/reportcard.htm.
About Vital Signs
Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journal Morbidity and Mortality Weekly Report, or MMWR. The new report provides the latest data and information on key health indicators. These are cancer prevention, obesity, tobacco use, alcohol use, HIV/AIDS, motor vehicle passenger safety, prescription drug overdose, health care-associated infections, cardiovascular health, teen pregnancy, asthma, and food safety.
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