Use of newborn screening infant feeding data to promote policy change in California hospitals

Breastfeeding initiation in California hospitals has increased in the last decade to more than 86% of new mothers (2006). However, in-hospital exclusive breastfeeding rates have remained virtually unchanged. The California Department of Public Health (CDPH) Genetic Disease Screening Program collects infant feeding information as part of the newborn screening. Annually, these data are made available to the public but have been little utilized. Methods: In an effort to promote model hospital policies shown to increase exclusive breastfeeding, the UC Davis Human Lactation Center, the California WIC Association (CWA), and the California Breastfeeding Coalition collaborated on two annual policy briefs and associated media outreach. The reports focused on associations between exclusive breastfeeding and maternal child health and compared hospitals' rates of supplementation of breastfed infants through the use of graphs, county rankings, and lists of the highest and lowest performing hospitals in the state. Press releases, talking points and conference calls were used to prepare coalitions for media inquiries. Results: The reports and fact sheets generated attention in major media markets throughout California resulting in efforts to change policies by many California hospitals. Technical assistance for this process was provided by state agencies, CWA, and some coalitions. Discussion: Use of policy briefs and media reports comparing hospital supplementation rates of breastfed infants was effective in creating momentum for policy change in California hospitals. Since the first report was released in 2006, 6 hospitals have become Baby-Friendly and others have sought technical assistance in adopting model policies from state and local entities.