Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting

• Published in: Pediatrics (Evanston) Vol. 108; no. 3; p. 677
• Main Authors: Philipp, B L, Merewood, A, Miller, L W, Chawla, N, Murphy-Smith, M M, Gomes, J S, Cimo, S, Cook, J T
• Format: Journal Article
• Language: English
• Published: United States 01.09.2001
• Subjects: Academic Medical Centers; Adult; African Americans - statistics & numerical data; Boston; Breast Feeding - statistics & numerical data; Female; Health Promotion; Humans; Infant, Newborn; Male; Policy Making; Boston
• ISSN: 1098-4275
• DOI: 10.1542/peds.108.3.677

Breastfeeding initiation rates were compared at Boston Medical Center before (1995), during (1998), and after (1999) Baby-Friendly policies were in place. Boston Medical Center, an inner-city teaching hospital that provides care primarily to poor, minority, and immigrant families, achieved Baby-Friendly status in 1999. Two hundred complete medical records, randomly selected by a computer, were reviewed from each of 3 years: 1995, 1998, and 1999. Infants were excluded for medical records missing feeding data, human immunodeficiency virus-positive parent, neonatal intensive care unit admission, maternal substance abuse, adoption, incarceration, or hepatitis C-positive mother. All infant feedings during the hospital postpartum stay were tallied, and each infant was categorized into 1 of 4 groups: exclusive breast milk, mostly breast milk, mostly formula, and exclusive formula. Maternal and infant demographics for all 3 years were comparable. The breastfeeding initiation rate increased from 58% (1995) to 77.5% (1998) to 86.5% (1999). Infants exclusively breastfed increased from 5.5% (1995) to 28.5% (1998) to 33.5% (1999). Initiation rates increased among US-born black mothers in this population from 34% (1995) to 64% (1998) to 74% (1999). Full implementation of the Ten Steps to Successful Breastfeeding leading to Baby-Friendly designation is an effective strategy to increase breastfeeding initiation rates in the US hospital setting.