CDC's Breastfeeding Report Card – United States: Using socioecologic indicators to track statewide breastfeeding support

Background: CDC's Breastfeeding Report Card – United States illustrates annual progress on indicators of breastfeeding protection, promotion, and support across all states.

Methods: First introduced in 2007, the Breastfeeding Report Card captures features of breastfeeding-friendly communities via indicators of hospital, health professional, and peer breastfeeding support, as well as legislation and public health professional infrastructure within a given state and the Healthy People 2010 breastfeeding objectives as measured by the CDC National Immunization Survey. Standard criteria were used to select indicators suitable for national, state, and trend analyses.

Results: The 2007 Report Card found only 3.3% of live births occurring at Baby-Friendly (BFHI) facilities. In Maine the proportion was 17%, however, 28 States reported none. National IBCLC availability was 2.2/1,000 live births, Vermont reported the highest coverage at 9/1,000. La Leche League groups were in every state, mean availability per 1,000 live births was 0.4. 46 States reported any breastfeeding legislation, with 15 specifically addressing employment issues. BFHI facility births and both IBCLC and La Leche League availability were correlated with at 3 month exclusive breastfeeding rates (r=0.36, r=0.5 and r=0.55 respectively). The 2008 Report Card will include adjustments reflecting new information and experiences gained since the 2007 iteration, while retaining the original baseline indicators. This presentation will highlight 2008 findings.

Conclusions: Federal reporting of breastfeeding indicators across the socioecologic model facilitates resource utilization, collaboration, and policy and environmental change. This helps identify opportunities to improve care, access to support, and public health infrastructure to ultimately improve breastfeeding outcomes nationwide.