Appx C-3_CDC_Web_Resources

Breastfeeding: Data: mPINC | DNPAO | CDC

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2007 CDC National Survey of Maternity Practices in
Infant Nutrition and Care (mPINC)
Introduction
Evidence shows that several specific practices in intrapartum medical care settings can
significantly affect breastfeeding rates and duration of breastfeeding among women. Birth facility
policies and practices that create a supportive environment for breastfeeding begin prenatally and
continue through discharge. In 2007, the Centers for Disease Control and Prevention (CDC), in
collaboration with Battelle Centers for Public Health Research and Evaluation, completed a
national survey of maternity care feeding practices and policies, entitled the Maternity Practices in Infant Nutrition
and Care (mPINC) Survey , at all facilities in the United States and Territories providing intrapartum care. The
survey was sent to all U.S. hospitals (n=3,143) and birth centers (n=138) with registered maternity beds, with a
request that it be completed by the person at the birth facility who had the most knowledge regarding the facility s
maternity and infant feeding practices. Data were obtained from a total of 2,690 (82%) of the facilities and are being
analyzed. CDC plans to repeat the survey to assess changes over time.

Questionnaires
Two versions of the questionnaire were developed that were identical in content but that contained minor
differences in wording to reflect the relevant type of staff and type of birth facility (hospital versus birth center;
hereafter birth facilities ) being surveyed. The survey contained 52 questions regarding the birth facility s
maternity practices, training, personnel, policy, and facility characteristics. Questions included a variety of response
options, including yes/no, ordinal responses (e.g., few, some, many, most), percentages, lists of program
components (e.g., elements of a worksite lactation program), or reasons for a given practice (e.g., why mothers and
infants are separated).
You can download the questionnaires here:
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Birth Center Survey (PDF-356k)
Hospital Survey (PDF-156k)

Results
Survey results have been analyzed by creating summary scores based on 34 questions related to maternity and infant
feeding practices. Scores were categorized into one of seven maternity care practice domains: labor and delivery;
postpartum breastfeeding assistance; postpartum contact between mother and infant; postpartum feeding of
breastfed infants; breastfeeding support upon discharge; staff breastfeeding training and education; and structural
and organizational factors related to breastfeeding.
Responses to specific items on the survey were scored according to an algorithm developed and reviewed by experts
in the field denoting the evidence and best practices to promote breastfeeding within the health care setting. Scores
were calculated for each item, then item scores were averaged to create a score for each of the 7 domains noted
above, and averages of the domain scores were used to create a total mPINC score. Possible scores ranged from 0—
100, with higher scores denoting better maternity care practices. Details on the mPINC scoring algorithm, including
rationale and explanations, can be found at Overview of the mPINC Scoring Algorithm.
CDC Web Resources
Appendix C-3
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Breastfeeding: Data: mPINC | DNPAO | CDC

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Results from the survey indicate that birth facilities in most states are not providing maternity care that is fully
supportive of breastfeeding. In addition, the southern region of the U.S., typically the region with the lowest
breastfeeding rates (see Map 1: Percent of Children Ever Breastfed by State among Children Born in 2004),
has the lowest maternity care practices scores. More information on the current status of maternity care practices
nationally, as well as by state, can be found in the June 13, 2008, MMWR article, Breastfeeding-Related
Maternity Practices among Hospitals and Birth Centers United States, 2007.
In addition to providing an overview of maternity care practices within the U.S., facility-specific benchmark reports
are being provided to each facility that completed a survey. The benchmark reports compare a facility s individual
scores on each of the maternity practice domains and the total score with those of facilities in their state and with
facilities of a similar size (i.e., number of births annually) nationally. These reports will help facilities identify
maternity care practices they can change to better support breastfeeding. Aggregate state-level data will be shared
with state health departments to facilitate their work with hospitals and birth centers in improving breastfeeding
care.
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Page last reviewed: June 10, 2008
Page last updated: June 10, 2008
Content Source: Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease
Prevention and Health Promotion
Page Located on the Web at http://www.cdc.gov/breastfeeding/data/mpinc/index.htm

CDC Web Resources

Appendix C-3

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