CDC: Hospitals Impede Breastfeeding

The nation’s hospitals are getting poor reviews for their efforts to encourage new mothers to breastfeed their infants, and that failure could worsen the childhood obesity problem in this country, according to a Hospital Support for Breastfeeding report from the Centers for Disease Control and Prevention.

“Most U.S. hospitals have policies and practices that do not conform to international recommendations for best practices in maternity care and interfere with mothers' abilities to breastfeed,” the CDC said, adding that “suboptimal breastfeeding in the United States annually results in an estimated $2.2 billion in additional direct medical costs.”

CDC conducted a national survey in 2007 and 2009 of more than 2,650 obstetric hospitals and a handful of birth centers to determine how many were providing maternity care practices that were consistent with the Ten Steps to Successful Breastfeeding guidelines. Those guidelines are part of the Baby-Friendly Hospital Initiative created by the World Health Organization and the United Nations Children’s Fund.

In 2009, the survey found that staff at 93% of hospitals provided prenatal breastfeeding education, 89% taught mothers breastfeeding techniques, and 82% taught feeding cues. However, only 14% of the hospitals had model breastfeeding policies, 22% limited breastfeeding supplement use, and 27% provided post-discharge support. From 2007 to 2009, the percentage of hospitals with recommended practices covering at least nine of 10 indicators increased only slightly, from 2.4% to 3.5%.

CDC recommended that hospitals providing maternity care adopt evidence-based practices to support breastfeeding. “Because nearly all births in the United States occur in hospitals, improvements in hospital policies and practices could increase rates of exclusive and continued breastfeeding nationwide, contributing to improved child health, including lower rates of obesity,” the CDC report said.

The Ten Steps to Successful Breastfeeding include:

1. Existence of a model breastfeeding policy;
2. Staff competency assessment;
3. Prenatal breastfeeding education;
4. Early initiation of breastfeeding;
5. Teaching breastfeeding techniques;
6. Limited supplementation of breastfeeding infants;
7. Rooming-in;
8. Teaching feeding cues;
9. Limited use of pacifiers;
10. Post-discharge support.

The majority of hospitals were implementing three to five recommended practices (60.5% in 2007 and 54.3% in 2009), with only 2.4% of hospitals implementing at least nine recommended practices in 2007, and 3.5% in 2009.

Less than 1% of hospitals implemented all 10 policies and practices either year.

“For women who intend to breastfeed, the hospital experience is critical. These data illustrate the persistent use of practices that are inconsistent with best-practice standards and do not support breastfeeding. To give infants the best start in achieving a healthy life, including reduced obesity, mothers must be supported immediately after birth to establish breastfeeding,” the report said.