Improving Breastfeeding Support in Hospitals

How Do Hospitals Support Breastfeeding?

Learning to breastfeed is a natural process, like walking, that relies on a lot of practice, especially at first. Good support makes it easier to get started; supportive champions make it easier to keep practicing through to mastery.

Supportive hospital practices include:

• Skin-to-skin contact – Doctors and midwives place newborns skin-to-skin with their mothers immediately after birth, with no bedding or clothing between them, allowing enough uninterrupted time (at least 30 minutes) for mother and baby to start breastfeeding well.

• Teaching about breastfeeding – Hospital staff teach mothers and babies how to breastfeed and to recognize and respond to important feeding cues.

• Early and frequent breastfeeding – Hospital staff help mothers and babies start breastfeeding as soon as possible after birth, with many opportunities to practice throughout the hospital stay.  Pacifiers are saved for medical procedures.

• Exclusive breastfeeding – Hospital staff only disrupt breastfeeding with supplementary feedings in cases of rare medical complications.

• Rooming-in – Hospital staff encourage mothers and babies to room together and teach families the benefits of this kind of close contact, including better quality and quantity of sleep for both and more opportunities to practice breastfeeding.

• Active follow-up after discharge – Hospital staff schedule in-person breastfeeding follow-up visits for mothers and babies after they go home to check-up on breastfeeding, help resolve any feeding problems, and connect families to community breastfeeding resources.

Most hospitals will provide this kind of care when requested, even if it's not their standard practice. Some hospitals* routinely provide this care to all maternity patients.

The Hospital's Role in Breastfeeding Support

Evidence-based care is the responsibility of every facility that provides maternity services. Systematic practice improvement enables patients to make and carry out their own informed decisions, highlighting medical professionals' role in providing patient-centered, evidence-based care.

CDC Maternity Practices in Infant Nutrition and Care (mPINC) Survey
In 2007, CDC administered the first national survey of maternity care practices related to breastfeeding, known as the Maternity Practices in Infant Nutrition and Care (mPINC) Survey to all facilities in the US and Territories that routinely provide this care.

This survey established a baseline measure of these practices and documented the extent to which practices vary by state.

Disseminating Findings
Data from the mPINC survey can be used to help meet local needs and improve care. Plans for sharing survey results include:

• Publishing a national report, the MMWR Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers --- United States, 2007

• Providing state aggregate reports to each State Health Department.

• Distributing Benchmark Reports to hospital administrators and medical and nursing management staff at each facility that responded to the survey.

For More Information

• CDC Breastfeeding Activities – CDC encourages an evidence-based policy and environmental approach to breastfeeding protection, promotion, and support.
• US Breastfeeding Committee (USBC)* – a national organization working to improve the nation's health by promoting and supporting breastfeeding.
• Baby-Friendly Hospital Initiative (BFHI)* – a program sponsored by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to encourage and recognize birth facilities that offer optimal lactation care.
• Baby-Friendly USA* – the designating authority for BFHI in the United States.