The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #54226

Anne Merewood, MA, IBCLC¹, Barbara L. Philipp, MD, IBCLC², Kirsten Malone, IBCLC¹, and Sabrina Cimo, MPH². (1) The Breastfeeding Center, Boston Medical Center, 850 Harrison Ave, ACC 5, Boston, MA 02118, 617-414-6455, anne.merewood@bmc.org, (2) Division of General Pediatrics, Boston University School of Medicine, Maternity Building, 4th Floor, 91 East Concord Street, Boston, MA 02118

Objective: To review the impact of Baby-Friendly status on breastfeeding rates at Boston Medical Center (BMC) an inner-city hospital with approximately 2000 births per year, where 57% of women giving birth are black; 23% are Hispanic; 55% receive Medicaid and 35% are uninsured. African Americans have the US’ lowest breastfeeding rates, initiating at almost half the rate of whites and Hispanics. Methods: 200 randomly selected medical records of healthy term neonates, and all records of surviving infants directly admitted to the Neonatal Intensive Care Unit (NICU) were reviewed for 1995 (prior to Baby-Friendly designation), and 1999 (year of Baby-Friendly designation). 200 medical records of term infants from 2000 and from 2001 were reviewed to identify status of breastfeeding rates over time. Results: Between 1995 and 1999, breastfeeding initiation rates among healthy term infants rose from 58% to 87% (p<.001), and exclusive breastfeeding rates rose from 6% to 34% (p<.001). Breastfeeding rates among US-born black women (the group with the nation’s lowest rates) rose from 34% (1995) to 74% (1999) (p=.001). Breastfeeding initiation rates in the NICU rose from 35% (1995) to 74% (1999) (p<.001). Breastfeeding initiation rates among US born black women with NICU infants rose from 34.5% in 1995 to 64% in 1999 (p=.03), and for non US born black women, from 27% (1995) to 81% (1999) (p=.001). These rates were sustained in subsequent years. Implications: The Baby-Friendly Hospital Initiative appears to raise breastfeeding rates in populations with traditionally low rates, and among healthy, sick, and premature infants.

Learning Objectives:

At the end of this presentation, the participant will be able to:
• Describe the Baby-Friendly Hospital Initiative (BFHI)
• Outline the role of the BFHI in increasing breastfeeding rates in underprivileged and minority populations
• List at least 3 of the "Ten Steps to Successful Breastfeeding"

Keywords: Breast Feeding, Ethnic Minorities

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.