June 16, 2008

CDC Releases New Report on Hospitals’ Support for Breastfeeding

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 Women's Health News]


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