141st APHA Annual Meeting

In This section

Breastfeeding in a US, inner-city neonatal intensive care unit: 10 years post Baby-Friendly designation

Monday, November 4, 2013 : 8:30 AM - 8:50 AM

Laura Burnham, MPH , Department of Maternal and Child Health, Boston University School of Public Health, Boston, MA
Margaret Parker, MD, MPH , Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA
John Cook, Ph.D. , Department of Pediatrics, Boston University School of Medicine, Boston, MA
Emily Sanchez , Breastfeeding Center, Boston Medical Center, Boston, MA
Barbara Philipp, MD , Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA
Anne Merewood, PhD, MPH, IBCLC , Division of General Pediatrics, Boston Medical Center, Boston, MA
Background: Human milk is particularly beneficial for infants admitted to the Neonatal Intensive Care Unit (NICU). The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991, but its application to the NICU was not clearly defined. The current international effort to develop guidelines and criteria for the “Baby-Friendly NICU” has led to a resurgence of interest in this field. Boston Medical Center (BMC), an inner-city, teaching hospital with a 22 bed, Level 3 NICU, published a study demonstrating an association between BFHI implementation and increased NICU breastfeeding in 1999. To date, no studies have evaluated the long-term association between the BFHI and breastfeeding in NICU infants. Our goal was to determine the association between the BFHI and breastfeeding in the NICU over time. Methods: We analyzed demographic and infant feeding data from medical records of all infants admitted to the BMC NICU in 1999 and 2009 and compared rates of initiation and exclusivity between the two years using Chi-square analyses. Results: We excluded infants who died, who were transferred, and whose mothers were not eligible to breastfeed. Breastfeeding initiation increased from 75% (74/117) in 1999 to 85% (85/142) in 2009 (p=0.04). For Black infants, breastfeeding initiation increased from 58% in 1999 to 86% in 2009 (p<0.001). Exclusivity at 2 weeks among all NICU infants did not change significantly between 1999 and 2009. Conclusion: Breastfeeding rates in a US, inner-city, level 3 NICU continued to improve 10 years after Baby-Friendly designation, and the increase was particularly significant among Black infants.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Discuss the impact of the Baby-Friendly Hospital Initiative on breastfeeding initiation and continuation in an inner-city US, level 3 NICU. Describe the impact of the BFHI on breastfeeding rates in a US NICU 10 years after designation

Keywords: Breastfeeding, High Risk Infants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently working toward my Master's in Public Health at Boston University's School of Public Health, and while in graduate school I have held an internship at Boston Medical Center's Breastfeeding Center and worked as a research assistant on the Breastfeeding in the NICU Study. The abstract, "Breastfeeding in a u.s. inner-city neonatal intensive care unit: 10 years post baby-friendly designation" is based on my work on this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.