Mothers and their newborns are provided full breastfeeding support in less than 4% of U.S. hospitals, according to a report released Aug. 2 by the Centers for Disease Control and Prevention.
Breastfeeding has been shown to lower medical costs and improve children’s health by decreasing the risks of diabetes, sudden infant death syndrome, and childhood obesity. Mothers also benefit from breastfeeding with lower rates of breast cancer and ovarian cancer, according to the report.
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According to CDC Director Thomas R. Frieden, breastfeeding for 9 months may reduce a baby’s chances of becoming overweight by more than 30%. A baby’s risk of becoming overweight also decreases with each month of breastfeeding. Additionally, one in three mothers who do not have enough hospital support stop breastfeeding earlier than recommended.
With many health factors that play into breastfeeding, the CDC encourages hospitals to provide more resources and training for mothers and babies on how to breastfeed early and properly (MMWR 2011;60:1-6).
The "perfect nutrition" for infants, breast milk contains the antibodies that infants cannot make until about 6 months of life, Dr. Frieden said in a press briefing.
"Although there has been some improvement in hospital practices to support mothers who want to breastfeed, we’re still a very long way from where we need to be," Dr. Frieden said. "Hospitals need to greatly improve practices to support mothers who want to breastfeed."
Using data from Maternity Practices in Infant Nutrition and Care (mPINC), the CDC’s national survey conducted every 2 years, only 14% of U.S. hospitals have a written breastfeeding policy. Only 33% of hospitals practice rooming in, which helps mothers establish intimacy and learn how to breastfeed.
Furthermore, about 80% of hospitals provided formula to healthy breastfeeding babies when it was not medically necessary, which can make learning how to breastfeed and continue to breastfeed at home even harder for mothers and babies, according to a written statement issued by the CDC.
There needs to be a "cultural change" in hospitals, said Dr. Frieden. In exchange for hospitals promoting special baby formula, it is common for hospitals to provide gift bags that include formula to give to women on discharge, which saves the hospital money for the specialty formulas.
However, "breastfeeding infants that are supplemented in the hospital unnecessarily are much less likely to continue breastfeeding exclusively or continue for longer durations once they go home," Dr. Cria Perrine, an epidemiologist from the CDC’s division of Nutrition, Physical Activity and Obesity, said during the press briefing.
One of the recommendations to support breastfeeding is for U.S. hospitals to become Baby-Friendly, indicating that breastfeeding support policies are consistent with the WHO/UNICEF’s Ten Steps to Successful Breastfeeding. Steps include giving no artificial nipples or pacifiers to breastfeeding infants, helping mothers to initiate breastfeeding within 1 hour of birth, and encouraging mothers to join breastfeeding support groups after discharge from hospitals.
"The steps are additive, and more is better: ideally all 10 steps, and they’re really not hard to get to if there’s a commitment from the top level of the hospital or hospital system to do so," Dr. Frieden said.
Earlier CDC studies found that the more Baby-Friendly practices a hospital implements, the more likely mothers will continue to breastfeed after leaving the hospital. Women were more than 10 times as likely to breastfeed at 2 months when they delivered at a hospital that practiced the 10 steps, according to Dr. Frieden.
"Baby-Friendly hospital practices work," he said. "They greatly increase the likelihood that women who want to breastfeed will breastfeed [and] that they will be breastfeeding in the hospital at discharge and months later."
In 2011, only two states, Alaska and Nebraska, had 20% or more of births in Baby-Friendly facilities, according to Baby-Friendly USA. Nineteen states, including the District of Columbia, had 0% of births in Baby-Friendly facilities in 2011. As of July 28, there are 114 Baby-Friendly hospitals and birth centers in the United States.
"At current trends, it will take more than 100 years before every baby in this country is born in a hospital where the hospital fully supports a mother’s desire to breastfeed," Dr. Frieden commented.
Community support is also an important recommendation that can lead to more successful breastfeeding. Currently only about one-fourth of hospitals practice and encourage community support, Dr. Frieden said.
"Supporting breastfeeding is something that needs to be done, not just by hospitals, but also by doctors and nurses who encourage women; by the federal government, which is promoting policies; by state and local governments that can have quality standards for hospitals and encourage hospitals to become Baby-Friendly; and by mothers and their families," he asserted.