A report out Tuesday from the Centers for Disease Control and Prevention finds that each year only 14 percent of 4 million newborns are born in hospitals that have been designated as “baby-friendly.”
To become certified as “baby-friendly,” hospitals must adopt 10 practices that research has shown to promote breast-feeding. Practices include communicating breast-feeding policy to hospital staff, helping mothers initiate breast-feeding within 30 minutes of birth, encouraging breast-feeding on demand, and giving newborns no food or drink other than breast milk unless medically indicated, such as when taking a prescription that could be harmful. Hospitals also must abide by the international code of marketing of breast-milk substitutes, meaning that they cannot accept free formula from companies. The designation process is conducted by Baby-Friendly USA, the accrediting body for the Baby-Friendly Hospital Initiative in the U.S.
The American Academy of Pediatrics endorsed the steps in 2009.
The latest hospital results, conducted through surveys every two years, were reported Tuesday in the CDC’s Vital Signs report.
It found that from 2007 to 2013, the percentage of hospitals that implemented a majority of the steps increased from 29 percent to 54 percent. Of about 3,300 of these hospitals, 289 received the “baby-friendly” designation. Some barriers include getting hospital leadership on board, or training staff, which can be time consuming, Cria Perrine, epidemiologist in CDC’s division of nutrition, physical activity and obesity, said in a call with reporters Tuesday.
More hospitals are using a majority of the Ten Steps to Successful Breastfeeding
Dr. Tom Frieden, director of the CDC, added that the 10 steps were not simple to implement, and could even take several years. “Frankly we are seeing more progress than we thought there would be,” he said.
These measures have been controversial for some. While some mothers have reported that they have find the standards helpful, others have said in news reports that they felt pressured to breast-feed.
But CDC wants hospitals to follow these steps because it says they can make a difference in whether and how long women breast-feed. In part because of antibodies in breast milk, babies who breast-feed have reduced risks of ear and respiratory infections, asthma, sudden infant death syndrome, diabetes and obesity. The American Academy of Pediatrics says breast-feeding also helps mothers return to their pre-pregnancy weight, reduces postpartum bleeding and reduces their risk of breast and ovarian cancer.
“Hospitals can give moms and their newborns the best chance for the best nutrition,” Frieden said during the call.
According to the report, 80 percent of babies in the U.S. start out breast-feeding, but 60 percent of moms reported that they stopped breast-feeding earlier than they wanted to. About 22 percent of babies are exclusively breast-fed for six months, and 29 percent of babies are breastfed for 12 months, as recommended by the American Academy of Pediatrics.
Though hospitals have made progress, the CDC report pointed to areas for improvement. Less than half of hospitals kept mothers with their babies throughout the entire hospital stay, and 32 percent of hospitals provided enough support for breast-feeding moms after they left the hospital. Results for the latter may improve in subsequent years as President Barack Obama’s health care law, the Affordable Care Act, has made breast-feeding counseling and supplies available to families with no out-of-pocket costs.
The push toward encouraging breast-feeding at U.S. hospitals is a result of the Baby-Friendly Hospital Initiative that UNICEF and the World Health Organization launched in 1991. The U.S. goal, outlined in Healthy People 2020 – a series of goals across various health factors – calls for reducing the proportion of infants who receive formula within two days of life to 14.2 percent. Data from 2011 show that current numbers have reached 19.4 percent, which is less than where the country was in 2006, at 24.2 percent.
“I’d really like to ask hospitals to keep making progress,” Frieden said. “Ideally we would like every birth hospital in the country to adopt all 10 steps and be ‘baby-friendly.'”