Hospital experiences and long-term breastfeeding success, California 2010

Background: Hospital maternity care practices influence infant feeding behaviors during a period critical for successful breastfeeding initiation. The prevalence of maternity care practices that support breastfeeding, and their association with long-term breastfeeding success, have not been well described in California.

Methods: The California Maternal and Infant Health Assessment (MIHA) is a statewide-representative survey of women with a recent live birth that collects self-reported information on infant feeding practices and maternal experiences immediately after delivery, including: rooming-in, early skin-to-skin contact and breastfeeding initiation, formula supplementation, pacifier use, and receipt of contact information for post-discharge support or a gift pack containing formula upon discharge from the hospital. MIHA 2010 data were analyzed to show the prevalence of these hospital practices and their association with breastfeeding behavior at three months postpartum among mothers of healthy newborns. Results: Most California mothers reported that their baby stayed in their room during the hospital stay (89%) and that the hospital gave them a telephone number to call for help with breastfeeding after discharge (85%). Only two-thirds reported initiating breastfeeding early (66%) and not using a pacifier while in the hospital (62%). Half reported not supplementing their infant with formula (54%), while less than half reported holding their infant skin-to-skin (43%) or not receiving a gift pack containing formula (43%). Only 10% reported experiencing all seven of these hospital practices. Mothers experiencing at least 6 of the 7 practices were more likely to exclusively breastfeed at three months postpartum (56%), compared to those only experiencing 0-2 or 3-5 practices (19% and 30%, respectively).

Conclusions: Establishing maternity care policies and practices that support breastfeeding as a standard of care in California hospitals will help meet Healthy People 2020 goals and improve overall maternal and child health.