Breastfeeding support lacking in U.S. hospitals and birth centers

Jun 15 2008

Many birth facilities in the United States are not providing maternity care that is fully supportive of breastfeeding, according to a study in today's Morbidity and Mortality Weekly Reports (MMWR), a publication of the Centers for Disease Control and Prevention.

Research has shown that what happens in the hospital or birth center plays a crucial role in establishing breastfeeding and helping mothers to continue breastfeeding after leaving the birth facility.

The study, "Breastfeeding-Related Maternity Care Practices among Hospitals and Birth Centers - United States, 2007," analyzed responses from nearly 2,700 birth facilities in all 50 states, the District of Columbia, and Puerto Rico. It asked birth facilities about their practices and policies in caring for women who choose to breastfeed their newborns. The practices were scored on a scale from 0 to 100 points.

The study found that hospitals and birth centers in many southern states scored lower in practices supportive of breastfeeding compared to other regions of the nation, with average total maternity practice scores ranging from 48 to 58. Seven southern states - Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma and West Virginia - also had the lowest percentages (less than 30 percent) of children who were breastfed for 6 months, according to the 2006 National Immunization Survey.

Western and New England states generally had higher scores compared to other parts of the country. Vermont and New Hampshire tied for the highest overall maternity practice scores (81), followed by Maine (77) and Oregon (74). In addition, Oregon, Maine and Vermont report that more than 75 percent of children were ever breastfed.

The study reported scores related to seven aspects of maternity care. Nationally, the average facility score was 63 for key maternity practices in infant nutrition and care.

Out of a possible 100 points, the national scores were: labor and delivery, 60; breastfeeding assistance, 80; mother-newborn contact, 70; postpartum feeding, 77; breastfeeding support after hospital discharge, 40; nurse/birth attendant breastfeeding training and education, 51; and structural and organizational quality, 66. The study also found that mean total scores combining all seven categories of practice varied significantly among states - ranging from a score of 48 in Arkansas to 81 in both New Hampshire and Vermont.

"These findings underscore the importance of improving the way hospitals and birth centers provide assistance, encouragement and support for breastfeeding," said Laurence Grummer-Strawn, Ph.D., chief of the nutrition branch in CDC's Division of Nutrition, Physical Activity and Obesity. "We have a great deal of work to do to accomplish our national objectives related to breastfeeding, and birth facilities can make a huge contribution to this effort."

National Healthy People 2010 objectives call for 75 percent of new mothers to initiate breastfeeding, 50 percent to continue for six months, and 25 percent to continue for one year. In addition, the national objectives have a goal for 40 percent of mothers to breastfeed exclusively for three months, and 17 percent of women to breastfeed exclusively for six months.

Studies show that both babies and mothers gain many benefits from breastfeeding. Breast milk contains antibodies that can protect infants from bacterial and viral infections. Breastfed babies are also less likely to become overweight compared to formula-fed babies. Research also indicates that women who breastfeed may have lower rates of diabetes and breast or ovarian cancers than women who don't breastfeed.