Gaps exist in hospital maternity care policies to support breastfeeding: Results from the 2007 CDC National Survey of Maternity Practices in Infant Nutrition and Care (mPINC)

Background: Hospital breastfeeding support is critical to successful initiation of lactation and long-term breastfeeding outcomes. The American Academy of Pediatrics recommends inclusion of specific elements in hospital maternity care policies to support breastfeeding. The objective of this study was to identify gaps in written policies and examine the association between policies and maternity care.

Methods: We used data from CDC's 2007 National Survey of Maternity Practices in Infant Nutrition and Care (mPINC) to examine 12 specific elements of hospital policies related to maternal education, breastfeeding initiation, management of lactation, and preparation for discharge at 2546 hospitals in the United States. We used CDC's mPINC maternity care practices score to examine the relationship between hospital policies and practices.

Results: Ninety-five percent of hospitals reported having at least one recommended element of a policy to support breastfeeding. Only 10 percent of hospitals had a comprehensive policy addressing each of the recommended elements. Approximately 75 percent of hospitals had policies that included asking mothers about their feeding plans. Fewer than half of all hospitals had policies that addressed use of pacifiers by breastfed infants or the referral of mothers to appropriate community breastfeeding resources upon discharge. Comprehensiveness of policy was highly correlated with maternity care practices and varied by hospital size, ownership, and region of country.

Conclusions: Significant gaps exist in hospital policies related to breastfeeding support. Comprehensive maternity care policies translate into evidence-based practices that support breastfeeding. Efforts to improve hospital policies are needed to support breastfeeding