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Too few hospitals support breastfeeding moms

Dominika Osmolska Psy.D.'s picture

This week – August 1-7 – is World Breastfeeding Week, inaugurated back in 1990 by The World Health Organization and UNICEF. The Innocenti Declaration, as the initiative is known, promotes and encourages women around the world to breastfeed their newborns, for the health benefits the practice confers on both baby and mother. Which is why health news this week is focusing on what hospitals are doing – or not doing – to promote breastfeeding among postpartum mothers.

Many hospitals do not support breastfeeding because they fail to adhere to best practices that promote it, according to a CDC report published in the August issue Vital Signs. Only a third of the 2,600 hospitals surveyed had a “model” breastfeeding policy, the data showed. The breastfeeding best practices were established by Baby-Friendly Hospital Initiative, a World Health Organization and United Nations program.

Some important steps to breastfeeding success include helping women start nursing within an hour of birth, even if the mother’s milk has not yet come in, keeping the baby and mother in one room for 24 hours a day rather than putting the baby in a nursery, and not giving supplemental nutrition, i.e. formula, unless medically necessary.

The Baby-Friendly recommendations don’t cost hospitals extra money, said Cria Perrine, the first author of the study. Hospitals that aren’t adhering probably aren’t doing so intentionally — they just don’t know what to do, she said.

I am not so sure. The key to successfully launching a new and inexperienced mother into breastfeeding is the tireless support and encouragement of lactation consultants. Sometimes, minor and predictable obstacles to breastfeeding, such as a delay in milk production or incorrect latching by the baby can result in premature discouragement. The nurses working in the labor and delivery unit simply do not have the time and expertise to sit with new mothers and troubleshoot nursing glitches. A small army of persistent lactation specialists would make a big difference – but hospitals would have to pay for their services.

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Breastfeeding confers many known health benefits to babies, but most women don’t meet the American Academy of Pediatrics’ recommendation of six months of exclusive breastfeeding plus another six months with food. Currently, only 15% of mothers breast feed exclusively for six months, and just 44% of those mothers are still feeding at all thereafter.

And few hospitals -- just 4% -- have adopted at least nine of the 10 principles spelled out in the Baby-Friendly Hospital Initiative. Nine percent have adopted no more than two.

Just about half of hospitals help mothers initiate breast feeding within the first hour after birth, the report said. And only a quarter give mothers breast feeding support -- such as a follow-up visit, a phone call, or referrals to lactation consultants -- after they leave the hospital.

A previous CDC study found that the Baby-Friendly criteria a hospital adopted, the more likely a woman was to go home breastfeeding.

Low rates of breast feeding add $2.2 billion a year to medical costs, which is based solely on healthcare costs alone and doesn't include lost productivity or other costs.

Data in the Vital Signs report come from the CDC's National Survey of Maternity Practices in Infant Nutrition and Care.