Majority of U.S. hospitals do not fully support breastfeeding

New CDC report shows missed opportunities for preventing childhood obesity beginning at birth

Breastfeeding protects against childhood obesity, yet less than 4 percent of U.S. hospitals provide the full range of support mothers need to be able to breastfeed, according to the most recent Vital Signs report released today by the Centers for Disease Control and Prevention. Improving rates of breastfeeding by providing better hospital support to mothers and babies is an important strategy to improve children′s health, including a reduced risk of childhood obesity.

“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, published online at www.cdc.gov/vitalsigns, examined data from CDC′s national survey of Maternity Practices in Infant Nutrition and Care (mPINC).  It finds that only 14 percent of hospitals have a written, model breastfeeding policy.  The report also finds that in nearly 80 percent 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 breastfeed and 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 percent 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, WIC 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:

Not giving healthy, breastfeeding infants food or drink other than breast milk unless there is a medical need for it;

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:

Implementing the Ten Steps to Successful Breastfeeding;

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.

For more information about CDC′s efforts to improve hospital practices to support breastfeeding, visit www.cdc.gov/breastfeeding. For more information about state breastfeeding rates and activities to support breastfeeding, visit 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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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES