CDC Report: Hospitals Need to Improve Breastfeeding Support

Aug. 2, 2011 -- Breastfeeding helps protect babies and mothers from many significant health risks, including childhood obesity and breast and ovarian cancers in mothers. Yet most hospitals in the United States fail to adequately support the practice, according to a new report from the CDC.

“We are a very long way from where we need to be,” CDC Director Thomas R. Frieden, MD, MPH, told reporters in a news conference.

The report, published in the August edition of the CDC’s monthly newsletter Vital Signs, states that less than 4% of hospitals follow at least nine of the 10 breastfeeding practices recommended by the World Health Organization/UNICEF Baby-Friendly Hospital Initiative, a program endorsed by the American Academy of Pediatrics.

Frieden said that although hospitals have shown some improvement in the past two years -- the report compares practices in 2007 and 2009 -- the pace of those improvements is much too slow.

At this rate, Frieden said, “it will be more than 100 years before every baby is born in a baby-friendly hospital.”

Breastfeeding Support

The AAP recommends that new mothers breastfeed their babies exclusively for the first six months after birth. Studies have shown that children who breastfeed are less likely to become obese, develop diabetes, or die of sudden infant death syndrome. Mothers are also protected by the practice. Breastfeeding has been associated with a lower risk of breast and ovarian cancers.

Most mothers-to-be say that they plan to breastfeed, and three-quarters of them do so. However, about half of new mothers give their babies formula within a week of birth. One reason for this, the authors of the CDC report write, is that hospitals fail to adequately support the practice.

“For women who plan to breastfeed, experiences and support during the first hours and days after birth influence their later ability to continue breastfeeding,” the authors write.

Most hospitals teach women about the benefits of breastfeeding and instruct them how to breastfeed and how to recognize when their baby is hungry. However, more than 85% of hospitals do not have a written breastfeeding policy; only 21.5% give healthy infants exclusively breast milk, unless there is a medical indication to supplement the diet; and just over a quarter provide what the authors consider adequate referral to breastfeeding support groups at time of discharge from the hospital.

Overall, just over half of hospitals followed three to five of the 10 recommended practices, which include the following:

• Having a written breastfeeding policy
• Training to implement the policy
• Breastfeeding education
• Initiation of breastfeeding within an hour of birth
• Breastfeeding training for expectant mothers
• Giving newborns a breast milk-only diet
• Allowing mother and newborn to room together 24 hours a day
• Encouraging breastfeeding on demand
• Eliminating the use of pacifiers
• Directing new mothers to breastfeeding support groups in the community

Implementing changes within hospitals to ensure that all of these practices are supported will take a lot of effort, Frieden said. Some hospitals, he said, are worried about what such changes will cost. But with the protective health benefits of breastfeeding, Frieden continued, short-term costs will likely be offset by long-term savings.

“Children who breastfeed will be less likely to come back to the hospital,” he said.