In-hospital support for breastfeeding: Results from the CDC National Survey of Maternity Care Practices in Infant Nutrition and Care (mPINC)

Background: Hospital breastfeeding support is critical to successful initiation of lactation and long-term breastfeeding outcomes.

Methods: From August 2007 through January 2008, CDC conducted a census of all U.S. birth facilities (hospitals and birth centers), assessing breastfeeding-related maternity care practices in terms of policies, personnel, staff training, prenatal education, postpartum care, and hospital discharge. Questionnaires were completed by the person in each facility most knowledgeable about infant feeding practices, typically a head maternity care nurse or the lactation coordinator.

Results: Approximately 80% (2676) of facilities responded—24% via internet, 76% by mail. Preliminary data from the first 1287 respondents indicates minimal staff breastfeeding training—71% of facilities provided £8 hours of training to new nurses, 40% said that over half of nurses received none in the past year. Approximately 85% receive free infant formula, and 70% distribute marketing samples to patients. Over half of mothers and babies room together in only 29% of facilities. 31% of facilities report postpartum skin-to-skin contact for a minority of infants. In 12%, the majority of breastfed newborns receive infant formula supplements. In 45% of facilities, staff give pacifiers to over half of infants. Among hospitals containing NICUs, only 11% report any banked human milk use.

Conclusions: Routine practices in many U.S. hospitals are deleterious to successful breastfeeding. Participating facilities as well as state health departments will receive these results, so they can use their own data to improve policies and practices at facilities throughout the country, thus improving maternal and infant health.