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CDC: Most U.S. Hospitals Do A Bad Job Supporting Breastfeeding

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Breastfeeding protects against childhood obesity, yet less than 4 percent of U.S. hospitals provide the full range of support mothers need to be able to breastfeed, according to the most recent Vital Signs report released Tuesday by the CDC.
“Hospitals play a vital role in supporting a mother to be able to breastfeed,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “Those first few hours and days that a mom and her baby spend learning to breastfeed are critical. Hospitals need to better support breastfeeding, as this is one of the most important things a mother can do for her newborn. Breastfeeding helps babies grow up healthy and reduces health care costs.”

The report also notes these pretty dismal findings:

-- Only 14 percent of hospitals have a written, model breastfeeding policy.


-- (And this one is astounding to me, hence the bold) In nearly 80 percent of hospitals, healthy breastfeeding infants are given formula when it is not medically necessary, a practice that makes it much harder for mothers and babies to learn how to breastfeed and continue breastfeeding at home.


--Only one-third of hospitals practice rooming in, which helps mothers and babies learn to breastfeed by allowing frequent chances to breastfeed.


--In nearly 75 percent of hospitals, mothers and babies do not get the support they need when they leave the hospital, including a follow-up visit, a phone call from hospital staff and referrals to lactation consultants, WIC and other important support systems in their community


Let's face it: it's not easy becoming that groovy earth mother you'd always imagined, the one who blissfully nurses her newborn with grace. It takes practice and guidance to get all that latching on and positioning working properly. And if your hospital is pushing formula while you're trying to figure it all out, it's no wonder you might feel like giving up.

Anne Merewood, director of The Breastfeeding Center at Boston Medical Center and associate professor of pediatrics at Boston University School of Medicine says one of the problems is cultural. "The U.S. has been a bottle-feeding nation for so long, formula was the norm in the hospital as well as society in general. It is hard to shake that influence, especially when the formula industry is still marketing aggressively."


That marketing includes those free goody bags filled with formula and other promotional paraphernalia that hospitals hand out to new mothers as they prepare to head home. About 70% of U.S. hospitals still give them out, Merewood says, despite a years-long campaign against it, and even as some hospitals start eliminating the formula bags, they are popping up in other places, like obstetrician and pediatricians' offices, she said.
But free formula isn't the only barrier to breastfeeding. Poorly trained staff, inconsistent advice from doctors and nurses and long-held practices such as keeping babies in the nursery away from moms are difficult to break, Merewood says.
It's not that women aren't trying. Studies show that moms already know that "breast is best" for both physical and emotional health, Merewood says. But that knowledge alone doesn't help them succeed. "I don't think it's a case of convincing them to breastfeed," she says. "It's a case of supporting them to breastfeed. Most women start out breastfeeding. But they quit — either it's undermined in the hospital, or sometimes, they don't have the confidence to keep going when things get tough. It's hard to believe you can do this when it's going wrong."
(Full disclosure here: I nursed my babies for a long, long time, like two years plus. Not exclusively, and not without some formula to get us all through the nights (and days) but still there was at least some flow of breast milk in their lives for a good stretch. Nevertheless, I'm not an ideologue: I get that it doesn't work for all women. But the least hospitals can do is lay the foundation to make breast-feeding as easy, accessible and trauma-free as possible.)
So, the bottom line message from the CDC is try harder and get help: Indeed, the report lists all the bad things that happen when breast-feeding rates, well, suck:

Low rates of breastfeeding add $2.2 billion a year to medical costs. Babies who are fed formula and stop breastfeeding early have higher rates of obesity, diabetes, and respiratory and ear infections, and tend to require more doctor visits, hospitalizations and prescriptions. Changing hospital practices to better support mothers and babies can improve these rates.

But help may be on the way: This week's announcement by the Obama administration that insurers must cover preventive health services for women got a lot of attention because free contraception is among those services. What didn't get much coverage is that free lactation consulting and breast feeding support will also be covered under the new federal order, which says:

Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their children’s and their own health. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.

At the very least, the CDC says, hospitals should:
· Not give healthy, breastfeeding infants food or drink other than breast milk unless there is a medical need for it;
· Encourage mothers to room in, staying with their baby 24 hours a day;
· Connect mothers with support groups and other resources to help with breastfeeding after they leave the hospital.

For information about improving hospital practices on breastfeeding look here, and for details on breastfeeding rates and activities related to improving them, go here.

This program aired on August 3, 2011. The audio for this program is not available.

Rachel Zimmerman Twitter Health Reporter
Rachel Zimmerman previously reported on health and the intersection of health and business for Bostonomix.

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