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APHA Scientific Session and Event Listing

Recorded presentation

Brian C. Castrucci, MA, Kathleen L. Hoover, M Ed, IBCLC, Suet Lim, PhD, and Katherine C. Maus, ACSW, LSW. Division of Maternal, Child and Family Health, Philadelphia Department of Public Health, 1101 Market Street, 9th Floor, Philadelphia, PA 19107, 609-828-3786, brian.castrucci@phila.gov

Objective. To compare rates of breastfeeding at hospital discharge between facilities that employ and do not employ International Board Certified Lactation Consultants (IBCLCs). Methods. This study used a cross sectional design. Data from 11,525 birth certificates of Philadelphia residents who delivered in 2003 were used. Breastfeeding was assessed using a question included on the Pennsylvania birth record, “Is the infant being breastfed at discharge?” Information on number of hours worked annually by IBCLCs by facility was collected by the Philadelphia Department of Public Health's lactation consultants. Results. After adjusting for race/ethnicity, education, insurance status, age, marital status, route of delivery, birth weight, and gestational age, delivering in a hospital that employed an IBCLC was associated with a 2.28 (95% CI: 1.98,2.62) times increase in the odds of breastfeeding at hospital discharge. Among women receiving Medicaid, delivering at a hospital that employed IBCLCs was associated with a 4.13 (95% CI: 3.22,4.80) times increase in the odds of breastfeeding at hospital discharge. Conclusions. The findings presented here identify an association between delivering at a facility that employs IBCLCs and breastfeeding at hospital discharge. As the strength of this association is not negligible, particularly for women on Medicaid, these findings may be used to encourage widespread use of IBCLCs.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the systems-level impact of lactation consultants on breastfeeding prior to hospital discharge.
• List those characteristics associated with lower breastfeeding rates.
• Explain the impact of lactation consultants at a system-level in differing populations.
• Explain how birth record data can be used to perform evaluations.

Keywords: Breast Feeding, Policy/Policy Development

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation