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Anne Merewood, MA, IBCLC1, Barbara L. Philipp, MD, IBCLC1, Supriya Mehta, MHS, PhD2, and Laura Beth Chamberlain, BA3. (1) Division of General Pediatrics, Boston University School of Medicine, Maternity Building, 4th Floor, 91 East Concord St., Boston, MA 02118, 617-414-6455, anne.merewood@bmc.org, (2) Department of Emergency Medicine, Boston University School of Medicine, Dowling 1 South, Room 1334, Boston, MA 02118, (3) The Breastfeeding Center, Boston Medical Center, YACC 5, 860 Harrison Ave, Boston, MA 02467
Background: Of 18,000 WHO/UNICEF Baby-Friendly hospitals worldwide, 36 are located in the United States. Objective: To review breastfeeding initiation rates, exclusive breastfeeding rates, demographics, and barriers to becoming Baby-Friendly at 29 US Baby-Friendly hospitals, and compare them with national statistics for the same year. Methods: In 2001, 32 US hospitals had Baby-Friendly status. By 2003, two had closed, and one was no longer Baby-Friendly. This study analyzed breastfeeding and demographic data from the remaining 29 hospitals. The data represented 34,365 US births. Results: The number of births per year at US Baby-Friendly hospitals in 2001 ranged from 37 to 4082, with a mean of 1227 and a median of 667.5 (95% CI). Most (15/29; 51/7%) self identified as community hospitals. In 2001, the mean breastfeeding initiation rate at US Baby-Friendly hospitals was 84.8% (range, 58%-100%; median: 85.3%), compared to a national breastfeeding initiation rate of 69.5%. The mean rate of exclusive breastfeeding during the hospital stay for the 16 reporting hospitals was 78.4% (range 25%-100%; median 86%), compared to a national exclusive rate of 46.3% during the hospital stay. Baby-Friendly hospitals were evenly distributed in regions with high and low breastfeeding rates: 17/28 were located in states with rates above the national average. In linear regression analysis, breastfeeding rates were not associated with number of births per institution. Initiation rates were highly positively correlated with state (p<0.001) and regional (p=0.001) rates, and only one Baby-Friendly hospital had a breastfeeding rate below its state average. The proportion of African American births was not associated with breastfeeding initiation rates. Statistically significant associations were observed towards lower breastfeeding rates in hospitals with staff pediatricians or obstetricians (p=0.0061), or with above average cesarean birth rates (p=0.007). The main barriers to implementation were (1) paying for formula (2) staff education, (3) rooming-in. Conclusions: The BFHI in the US is associated with elevated breastfeeding initiation rates. Nationally, African Americans have the lowest breastfeeding rates, but high percentages of African Americans at US Baby-Friendly hospitals were not associated with lower breastfeeding rates.
Learning Objectives: At the end of this presentation, the participant will be able to
Keywords: Breast Feeding, Hospitals
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.
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Recorded presentation