Publication Title: 
Publication Date: 
Wednesday, July 5, 2017

Exclusive breastfeeding for the first six months, with continued human breast milk feeding through 12 months or longer, is recommended to provide optimal infant and maternal health benefits. Maternity care provided during birth hospitalization has been shown to directly impact breastfeeding success. The Ten Steps to Successful Breastfeeding (Ten Steps), individually or combined, have been associated with reduced formula supplementation, increased exclusive breastfeeding, and longer breastfeeding duration through at least eight weeks of age. Because US insurance carriers are required to cover 48 hours of newborn care, most infants spend the first two days in the hospital.

This study finds that formula supplementation of breastfed infants varies across hospitals in New York. Much of this variation persists even after adjusting for maternal and infant factors. Hospital breastfeeding policies and supplementation practices contribute to this variation. Improving hospital practices could lead to improved breastfeeding outcomes.

A better understanding of the exemplar hospitals could inform future efforts to improve maternity care practices and breastfeeding support to reduce unnecessary formula supplementation, reduce disparities, increase exclusive breastfeeding and breastfeeding duration, and improve maternal and child health outcomes.