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pdfDEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
Centers for Disease Control
and Prevention (CDC)
Atlanta, GA 30341-3724
December 19, 2012
«cRecipient»
«FacName»
«FacStreet»
«FacCity», «FacST» «FacZIP»
Dear «cRecipient»:
Thank you for participating in the Centers for Disease Control and Prevention’s 2011 survey of Maternity
Practices in Infant Nutrition and Care (CDC mPINC survey). As one of 2,738 mPINC survey respondents,
representing 83% of facilities in the nation that provide maternity services, «FacName»’s participation
demonstrates commitment to continuous quality improvement.
Enclosed is your Benchmark Report from the 2011 mPINC survey. CDC provides this customized Report to key
leadership personnel at each participating facility. Your Report summarizes the scientific rationale behind your
facility’s mPINC score, highlights strengths and quality improvement opportunities identified through your
survey responses, and illustrates how practices and policies at your facility compare with others of similar size,
across «statename», and nationwide. The mPINC Composite Quality Practice Score* for «FacName» was
«Total_score» out of 100. Across «statename» facilities, the average score was «ST_Score», and the national
average mPINC score was 70.
Your participation in the mPINC survey helps improve our national understanding of maternity care and
breastfeeding, making possible reports such as the CDC Vital Signs report, Hospital Support for Breastfeeding:
Preventing Obesity Begins in Hospitals (enclosed). The mPINC data describe the status of maternity care,
highlight the importance of improving maternity care practices, and take action to optimally support all mothers
and babies.
We hope you will find your Benchmark Report and the Vital Signs report useful in your ongoing efforts to make
systemic changes to optimally support the mothers and babies in your care. Thank you again for your dedication
to quality improvement in this critically important area of health care delivery. Please feel free to contact us at
[email protected] with any questions you may have.
Sincerely,
Laurence M. Grummer-Strawn, MPA, MA, PhD
Chief, Nutrition Branch
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention
cc: «aAdminNAME»«aComma» «aAdminTitle»
«bRespFirst» «bRespLastName»«bComma» «bRespTitle»
«dRecipient»
«eRecipient»
«fRecipient»
*
Details about the mPINC survey methodology, scoring, rationale, and history are at www.cdc.gov/mpinc .
«FacID»_c
Maternity Practices in Infant Nutrition and Care—mPINC
Quality Practice Measures
Benchmark
Report
2011 Survey
Fantastic Medical Center
123 Street Road
City, ST 12345
Facility ID: Test5
National Center for Chronic Disease Prevention and Health Promotion
Division of Nutrition, Physical Activity, and Obesity
2011 Quality Practice Measures
Summary Information
Fantastic Medical
Center’s Composite
Quality Practice Score:
What is the
mPINC Survey?
44
The Maternity Practices in Infant Nutrition and Care (mPINC) Survey is a national survey of infant
feeding practices in facilities that provide maternity care services.
The Battelle Centers for Public Health Research and Evaluation has conducted this survey for the
Centers for Disease Control and Prevention every other year since 2007.
Fantastic Medical Center’s
Composite Quality Practice Score Percentilesi
United States
(Percentile compared to all facilities nationwidei)
State
(Percentile compared to all facilities in State)
Similar
Size Facilities
(Percentile compared to all US facilities with
<250 births per yearii)
████████████
████████████ 25
█████████████████████████
█████████████████████████
50
█████████████████████████████████████
█████████████████████████████████████
75
0
100
Fantastic Medical Center reported 154 births in the past year; it is in the size category of <250 births per
year.
1
i Your facility’s percentile is the point below which the indicated percent of scores fall in each group. For example, if your National percentile is 50, then you are performing
better than half of all facilities nationwide. If your State percentile is 66 or 67, you are performing better than about two-thirds of the facilities in your state. If your Similar Size
percentile is 99, you are performing better than almost all other facilities nationwide with a similar number of births per year.
ii Facility size estimates are based on annual birth census as reported by the mPINC survey respondent and/or the American Hospital Association (when respondent did not
provide data).
What’s in this report?
Fantastic Medical Center’s results from the 2011
CDC mPINC Survey—CDC provides this resource to
help you improve outcomes by providing the best
evidence-based care to your patients.
Summary Information—Examine your Composite
Quality Practice Score.iii Scores range from 0 to 100;
your score compares to all other facilities: across the
US; in State; and in your size category nationwide.ii
Care Dimension Information—Learn about your
subscoresiv and percentiles in: labor and delivery
care; postpartum feeding of breastfed infants,
breastfeeding assistance, and contact between
mother and infant; staff training; and structural and
organizational aspects of care delivery.
Accompanied with each score are explanations of
how and why CDC chose to measure these
particular practices.
Who responded to the mPINC Survey?
All facilities that provide intrapartum care in the United
States and Territories received the mPINC survey.
At each facility, surveys were completed by the person most
knowledgeable about the care processes and policies
involved in feeding healthy infants.
The 2011 survey response rate was 83%.
Maternity Care Practices
and Infant Feeding
A group of specific interventions has been identified
that, when implemented together as a consistent system
of care,1-3 results in better breastfeeding outcomes.4-8
Inpatient and ambulatory intrapartum care strategies
describe how infant feeding care is delivered across the
perinatal period. These strategies are designed to
reduce the incidence of events and experiences that
undermine mothers’ breastfeeding intentions and
decisions.
The key components of this care system were
identified using the best available science and evidence.
Like other clinical care models, this evidence spans a
wide range, from results of randomized trials to expert
opinion, producing a set of connected best practices
that make up a facility’s infant feeding care system.
Components of
infant feeding care
best practices
The following key clinical care processes,
policies, and staffing expectations are
appropriate for care of all perinatal
patients, unless medically contraindicated:
I. Labor and delivery care—Upon
delivery,v the newborn is placed skinto-skin with the mother, allowing
uninterrupted time for breastfeeding.
II. Postpartum care:
a. Feeding of breastfed infants—The
breastfeeding infant is only offered
pacifiers and supplements (infant
formula, water, and glucose water)
when medically indicated;
b. Breastfeeding assistance—
Assistance is offered to the
breastfeeding mother and infant using
consistent standards for supportive
patient education and assessment;
c. Contact between mother and
infant—The infant is enabled to stay
with the mother 24 hours per day,
without unnecessary separation or
restrictions.
III. Facility discharge care—The
breastfeeding mother and infant are
assured ambulatory breastfeeding
care; patient discharge gifts contain
no infant formula marketing
samples.
IV. Staff training—All staff with
primary responsibility for care of the
breastfeeding mother and infant
receive appropriate breastfeeding
skills training and assessment.
V. Structural and organizational
aspects of care delivery—Best
practices policies are implemented
for staffing, care process, and
communication expectations in
perinatal patient education and care
settings; are supportive of
breastfeeding employees; and are
free from financial conflict of
interest.
iii The
Composite Quality Practice Score is a simple average of subscores from each care dimension.
care dimension subscore is the calculated simple average of scored items within each dimension.
v Immediate skin-to-skin contact and breastfeeding opportunities are possible and beneficial in both vaginal and Cesarean deliveries. These practices should be initiated within
one hour of vaginal birth and within two hours of Cesarean birth.
iv The
2
Subscore Percentiles:
I. Labor and Delivery
Care
United States
Subscore:
12
State
Similar Size Facilities
██
5
█
3
█
2
0
Measure
Initial skin-toskin contact
Ideal
Response
Your
Response
Your
Score
This measure reports how many patients experience
mother-infant skin-to-skin contact for at least 30 minutes
within 1 hour of uncomplicated vaginal birth.
Most
Few
0
This measure reports how many patients experience
mother-infant skin-to-skin contact for at least 30 minutes
within 2 hours of uncomplicated Cesarean birth.
Most
Few
0
This measure reports what percent of patients have the
opportunity to breastfeed within 1 hour of uncomplicated
vaginal birth.
≥90
20
30
≥90
10
30
Almost
always
Rarely
0
Rationale
Skin-to-skin contact improves infant ability to
establish breastfeeding.9
Explanation
Initial
breastfeeding
opportunity
Early initiation of breastfeeding increases overall
breastfeeding duration and reduces a mother’s risk
This measure reports what percent of patients have the
of delayed onset of milk production.10
Routine
procedures
performed
skin-to-skin
Performing routine newborn procedures and
assessments skin-to-skin increases infant stability,
is safe for mother and infant,11 and improves
breastfeeding outcomes by reducing unnecessary
separation of mother and infant.12
opportunity to breastfeed within 2 hours of uncomplicated
Cesarean birth.
II. Postpartum Care—
a. Feeding of Breastfed
Infants
Measure
Rationale
Initial feeding
received after
birth
Neonatal immune system development depends
on transfer of specific antibodies through
colostrum and is impaired by prior introduction of
non-breast milk feeds.13,14
Supplementary
feedings
The AAP and ACOG Guidelines for Perinatal Care15
and Academy for Breastfeeding Medicine
guidelines for supplementing feedings in healthy16
and hypoglycemic17 neonates all recommend
against routine supplementation with formula,
glucose water, or water.
3
100
This measure reports how often patients have routine infant
procedures performed while mother and infant are skin-toskin.
Subscore Percentiles:
United States
Subscore:
58
State
Similar Size Facilities
██████████
███████
█████
20
15
10
0
100
Ideal
Response
Your
Response
Your
Score
This measure reports what percent of breastfeeding infants
receive breast milk as their first feeding after uncomplicated
vaginal birth.
≥90
100
100
This measure reports what percent of breastfeeding infants
receive breast milk as their first feeding after uncomplicated
Cesarean birth.
≥90
90
100
This measure reports what percent of breastfeeding infants
receive non-breast milk feedings.
<10
50
30
This measure reports whether breastfeeding infants receive
glucose water and/or water.
No
Yes
0
Explanation
Subscore Percentiles:
II. Postpartum Care—
b. Breastfeeding Assistance
United States
Subscore:
61
State
Similar Size Facilities
███████████████
██████████
███████
30
20
15
0
Measure
Documentation
of feeding
decision
Breastfeeding
advice and
counseling
Explanation
Ideal
Response
Your
Response
Your
Score
This measure reports how often infant feeding decisions are
documented in medical records.
Almost
always
Almost
always
100
Most
Most
100
This measures reports how many patients are taught to
recognize and respond to infants’ cues instead of feeding on
a set schedule.
Most
Most
100
This measure reports how often breastfeeding patients
receive instructions to limit suckling at the breast to a
specific length of time.
Rarely
O en
30
This measure reports how many patients received a directly
observed breastfeeding assessment by facility staff.
Most
Most
100
Standardized breastfeeding assessment tools
This measure reports whether breastfeeding is assessed
improve comparability and validity of findings.23-25 using a standardized or adapted assessment tool.
Yes
No
0
In-hospital pacifier use reduces duration of
exclusive breastfeeding.26
Few
Most
0
Rationale
Standard documentation of infant feeding
decisions is important in order to adequately
support maternal choice.18
The AAP recommends pediatricians provide
parents with complete, current information on the
This measure reports how many patients who are
benefits and methods of breastfeeding to ensure
breastfeeding, or intend to breastfeed, are provided advice
that the feeding decision is a fully informed one.19 and instructions about breastfeeding.
Patient education is important in order to establish
breastfeeding.20,21
Effective breastfeeding relies on feeding in direct
response to specific infant cues rather than
scheduled frequency or duration of feedings.22
Assessment and
observation of
breastfeeding
sessions
Pacifier use
100
The AAP recommends formal evaluation of
breastfeeding performance by trained observers
during the first 24-48 hours of life.19
This measure reports how many breastfeeding patients are
given pacifiers by facility staff.
Subscore Percentiles:
II. Postpartum Care—
c. Contact Between
Mother and Infant
United States
Subscore:
Measure
Rationale
Separation of
mother and
newborn during
transition to
receiving units
Separation during transition to postpartum care is
unnecessary for stable patients. Mother-infant contact
is important during this time to establish breastfeeding,
maintain infant weight, and improve regulation of
infants’ neurologic states.22
Patient
rooming-in
Rooming-in of mother-infant pairs increases infants’
opportunities to learn to breastfeed28 and increases
duration and quality of maternal sleep.29
Instances of
mother infant
separation
Understanding the reasons mother-infant pairs are
separated30 helps identify opportunities to reduce
unnecessary separations. Bringing the infant to the
mother to breastfeed reduces chances the infant will
receive supplemental feeds.31,32
72
State
Similar Size Facilities
████████████████████
███████████████
██████████
40
30
20
0
100
Ideal
Response
Your
Response
Your
Score
This measure reports how many minutes motherinfant pairs are separated after uncomplicated vaginal
births during the transition from labor and delivery
care to their receiving patient care units.
No
separation
No
separa on
100
This measure reports how many hours breastfeeding
mother-infant pairs are separated at night.
No
separation
1
90
This measure reports what percent of mother-infant
pairs room together ≥23 hrs per day.
≥90
0
0
0
2
70
Most
NA‐all
room in
100
Explanation
This measure reports the number of reasons that
infant patients are removed from mothers’ rooms.
This measure reports how many patients who are not
rooming-in receive the infant from the nursery for
breastfeeding at night.
4
Subscore Percentiles:
III. Facility Discharge
Care
United States
Subscore:
38
State
Similar Size Facilities
██████████████████████████████
████████████████████
███████████████
60
40
30
0
Measure
Rationale
Explanation
Assurance of
ambulatory
breastfeeding
support
This measure reports how many modes of ambulatory
The AAP clinical practice guidelines recommend
examination of all infants by a qualified health care breastfeeding support are offered:
Physical Contact—Home/hospital visit;
professional within 48 hours of hospital discharge
Active Reaching Out—Phone call to patient;
33
to assess breastfeeding. Ensuring post discharge
Referral—Providing information about:
ambulatory support improves breastfeeding
Available phone numbers, support groups, lactation
34-35
outcomes.
consultant/specialist, WIC, outpatient clinics.
Distribution of
“discharge
packs”
containing
infant formula
The AAP and ACOG recommend against
distributing infant formula “discharge packs”14,36
because it reduces exclusive breastfeeding rates
and implies health care professional endorsement
of specific commercial items.37-39
100
Ideal
Response
Your
Response
Your
Score
All 3 modes
Modes 1
and 3
75
No
Yes
0
This measure reports whether breastfeeding patients are
given “discharge packs” containing product marketing
infant formula samples.
Subscore Percentiles:
United States
IV. Staff Training
Subscore:
‐‐‐
State
Similar Size Facilities
█████████████████████████████████████
█████████████████████████
████████████
25
0
Measure
Preparation of
new staff
Continuing
Education
Supplementary
feedings
Rationale
Staff training ensures standard capacity to provide
evidence-based care, learn about new information, and
maintain patient support skills.39-42 Standard 18 hour
staff training improves patient breastfeeding outcomes
facility-wide.43,44
100
Ideal
Response
Your
Response
Your
Score
This measure reports how many hours of
breastfeeding education new nurses and other birth
attendants* receive.
≥18
None
0
This measure reports how many hours of
breastfeeding education current nurses and other birth
attendants* receive.
≥5
Not sure
‐‐‐
This measure reports how many nurses and other
birth attendants* received any breastfeeding education
in the past year.
Most
Not sure
‐‐‐
At least once
a year
At least
once a
year
100
Explanation
Like other critical nursing competencies, regular
This measure reports how often nurses and other
birth attendants* are assessed for competency in
assessment of competency in breastfeeding
management and support improves delivery of care.45-47 breastfeeding management and support.
* In free-standing birth centers, these questions were asked among
“birth attendants” to accommodate the range of attendants to births in
these facilities.
5
75
50
Subscore Percentiles:
V. Structural & Organizational
Aspects of Care Delivery
Subscore:
26
United States
█
3
State
█
2
Similar Size Facilities
▋
1
0
Measure
Breastfeeding
policy
Ideal
Response
Your
Response
Your
Score
10
2
20
This measure reports the modes used to inform staff about
breastfeeding policies:
In person—In-service training, new staff orientation,
new staff training, staff meeting;
Printed/online materials—Policy posted, newsletter.
Both
modes
Both
modes
100
This measures reports your facility’s policy for
documentation of patient infant feeding plans and practices.
Any point
during or
post-stay
At
admission
only
25
3 critical
1 cri cal,0
addi onal
35
Rationale
The AAP recommends inclusion of specific
elements in facility breastfeeding policies.14 The
Academy of Breastfeeding Medicine’s clinical
protocol lists components of a model
breastfeeding policy.16
Effective intra-professional communication
Communication
increases the likelihood that a facility’s
of breastfeeding
breastfeeding policy will be implemented
policy
appropriately.48,49
100
Explanation
This measure reports the number of model breastfeeding
policy elements in your facility’s breastfeeding policy.
Infant feeding
documentation
policy
Standardized documentation of patient decisions
allows for valid internal assessment, monitoring
and improvement of quality of care, and improves
staff collaboration and support of patients’
decisions.50
Employee
breastfeeding
support
This measure reports how many supports are provided to
The AMA and AWHONN recommend medical
lactating staff:
facilities support all lactating employees by
Critical supports—Room to express milk, electric breast
providing appropriate time and facilities to express
pump for staff use, permission to express milk on breaks;
51,52
The US
and store milk during the work day.
Additional supports—On-site child care, breastfeeding
Breastfeeding Committee recommends specific
support group for staff, access to lactation consultant/
53
workplace supports.
specialist, paid maternity leave other than accrued leave.
Facility receipt
of free infant
formula
The ADA guidelines for mandatory elements of
infant formula HACCP plans54 apply to purchased
and free infant formula. The AMA recognizes the
inherent conflict of interest this kind of financial
support introduces.55,56
This measure reports whether your facility receives infant
formula free of charge from manufacturers.
No
Yes
0
Prenatal
breastfeeding
instruction
Patient education about breastfeeding improves
breastfeeding rates.20
This measure reports whether breastfeeding is a component
of prenatal patient education opportunities.
Yes
No/not
sure
0
This measure reports whether your facility has a designated
person who oversees lactation care within the facility.
Yes
No
0
A designated Lactation Coordinator demonstrates
Coordination of
consideration of lactation support as an essential
lactation care
and necessary function of intrapartum care.57
Next Steps
Example
Improvement
Opportunities
Examine the care dimension that was the most problematic at Fantastic Medical Center
compared to others in State or across the country, and choose one care process or policy to
begin improving.
I.
Labor and delivery care—Reduce delays
in first contact and breastfeeding
opportunities.
II. Postpartum care:
a. Feeding of breastfed infants—Eliminate
unnecessary supplementation;
b. Breastfeeding assistance—Improve
patient education and assistance; and
c. Contact between mother and infant—
Eliminate unnecessary separations
between mothers and infants.
III. Facility discharge care—Ensure compliance
with AAP clinical practice recommendations.
IV. Staff training—Facilitate staff training on
breastfeeding management and support.
V. Structural and organizational aspects of care
delivery—Improve your facility’s policies
related to breastfeeding.
6
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For more information visit:
www.cdc.gov/mpinc
Division of Nutrition, Physical Activity, and Obesity
National Center for Chronic Disease Prevention
and Health Promotion
Centers for Disease Control and Prevention
Atlanta, GA USA
August 2012
August 2011
30%
Breastfeeding for 9 months
reduces a baby’s odds of
becoming overweight by
more than 30%.
1 in 3
Even mothers who
want to breastfeed have
a hard time without
hospital support; about
1 mother in 3 stops
early without it.
5%
Hospital Support
for Breastfeeding
Preventing obesity begins
in hospitals
Childhood obesity is an epidemic. In the US,
1 preschooler in 5 is at least overweight, and half
of these are obese. Breastfeeding helps protect
against childhood obesity. A baby’s risk of becoming an overweight child goes down with each
month of breastfeeding. In the US, most babies
start breastfeeding, but within the first week,
half have already been given formula, and by 9
months, only 31% of babies are breastfeeding at
all. Hospitals can either help or hinder mothers
and babies as they begin to breastfeed. The BabyFriendly Hospital Initiative describes Ten Steps to
Successful Breastfeeding that have been shown to
increase breastfeeding rates by providing support
to mothers. Unfortunately, most US hospitals
do not fully support breastfeeding; they should
do more to make sure mothers can start and
continue breastfeeding.
About 5% of US babies are
born in hospitals that are
designated Baby-Friendly.
See page 4
Want to learn more? Visit
www
http://www.cdc.gov/vitalsigns
National Center for Chronic Disease Prevention and Health Promotion
Division of Nutrition, Physical Activity, and Obesity
1
Most hospitals do not fully
support breastfeeding
Problem
1.
Breastfeeding helps protect against
childhood obesity and other illnesses,
and lowers medical costs.
◊ The American Academy of Pediatrics
recommends babies be fed nothing but breast
milk for about the first 6 months and continue
breastfeeding for at least 1 year.
◊ Babies who are fed formula and stop
breastfeeding early have higher risks of obesity,
diabetes, respiratory and ear infections, and
sudden infant death syndrome (SIDS), and tend
to require more doctor visits, hospitalizations,
and prescriptions.
◊ Low rates of breastfeeding add $2.2 billion a
year to medical costs.
◊ Mothers who breastfeed have lower risks of
breast and ovarian cancers.
2. Hospitals should do more to
help mothers start and continue
breastfeeding.
◊ Hospitals that wait to start the first
breastfeed, or separate babies from mothers,
or routinely give formula to breastfeeding
babies make it harder for mothers and babies
to be able to breastfeed.
◊ When hospitals support mothers to feed their
babies only breast milk, it helps mothers to
continue feeding only breast milk at home.
3. Baby-Friendly hospitals make
special efforts to support mothers to
breastfeed.
◊ The World Health Organization/UNICEF
Baby-Friendly Hospital Initiative, endorsed
by the American Academy of Pediatrics,
recognizes hospitals that follow the Ten
Steps to Successful Breastfeeding.
◊ When hospitals have more of the Ten Steps
to Successful Breastfeeding in place, mothers
breastfeed longer.
The Baby-Friendly Ten Steps to Successful Breastfeeding
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
2
Have a written breastfeeding policy that is routinely communicated to all health care staff.
Train all health care staff in skills necessary to implement this policy.
Inform all pregnant women about the benefits and management of breastfeeding.
Help mothers initiate breastfeeding within 1 hour of birth.
Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
Give newborn infants no food or drink other than breast milk, unless medically indicated.
Practice “rooming in”— allow mothers and infants to remain together 24 hours a day.
Encourage breastfeeding on demand.
Give no pacifiers or artificial nipples to breastfeeding infants.
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the
hospital or clinic.
SOURCE: www.babyfriendlyusa.org/eng/10steps.html
Percentage of any and exclusive breastfeeding
by month since birth among US infants born in 2008
Percentage of US Infants
75
69
75
Any Breastfeeding
64
59
Exclusive Breastfeeding*
52
50
52†
47
44
*Exclusive breastfeeding = infant receives only
breast milk and vitamins or medications, but no
other solids or liquids.
46
40
SOURCE: CDC National Immunization Survey
35
25
27
†
19
Estimated at 7 days after birth
15
0
0
1
2
3
4
5
6
Months
Percentage of US hospitals with recommended policies and
practices to support breastfeeding, 2007 and 2009
2007
Model breastfeeding policy
Staff competency assessment
Prenatal breastfeeding education
Early initiation of breastfeeding
Teach breastfeeding techniques
Limited use of supplements
Rooming-in
Teach feeding cues
Limited use of pacifiers
Post-discharge support
2009
SOURCE: CDC National Survey of Maternity
Practices in Infant Nutrition and Care (mPINC)
Percentage of hospitals by number of
recommended policies and practices
to support breastfeeding in 2009
0
25
50
75
100
9–10 practices
4%
6–8 practices
33%
Percentage of US Hospitals
US State Info
0–2 practices
9%
3–5 practices
54%
Percentage of births at Baby-Friendly facilities in 2011, by state
WA
AK
MT
ND
ME
MN
OR
ID
VT
SD
HI
WI
WY
NV
CT
IA
NE
PA
IL
UT
CA
CO
KS
AZ
OK
NM
NH
MA
NY
MI
OH
IN
MO
VA
0%
NJ
DE
WV
RI
MD
D.C.
>0–9%
KY
NC
TN
AR
SC
MS
GA
10–19%
20% or more
AL
TX
LA
FL
SOURCE: Baby-Friendly facilities in 2011
(www.babyfriendlyusa.org) and CDC National Center
for Health Statistics 2009 Live Births
3
What Can Be Done
We must help hospitals support mothers to breastfeed.
Federal government can
Doctors and nurses can
◊ Promote maternity care policies and practices
that increase breastfeeding rates.
◊ Help write hospital policies that help every
mother be able to breastfeed.
◊ Track hospital policies and practices that
support mothers to be able to breastfeed.
◊ Learn how to counsel mothers on breastfeeding during prenatal visits, and support
breastfeeding in the hospital and at each
pediatric doctor’s visit until breastfeeding
stops.
◊ Help all federal hospitals implement the Ten
Steps to Successful Breastfeeding.
State and local government can
◊ Set statewide maternity care quality standards
for hospitals to support breastfeeding.
◊ Help hospitals use the Ten Steps to Successful
Breastfeeding, starting with the largest hospitals
in the state.
Hospitals can
◊ Partner with Baby-Friendly hospitals to learn
how to improve maternity care.
◊ Use CDC’s Maternity Practices in Infant
Nutrition and Care (mPINC) survey data to
prioritize changes to improve maternity care
practices.
◊ Include lactation consultants and other
breastfeeding experts on patient care teams.
◊ Coordinate lactation care between the
hospital and outpatient clinic.
Mothers and their families can
◊ Talk to doctors and nurses about breastfeeding plans, and ask how to get help with
breastfeeding.
◊ Ask about breastfeeding support practices
when choosing a hospital.
◊ Join with other community members to
encourage local hospitals to become
Baby-Friendly.
◊ Stop distributing formula samples and
give-aways to breastfeeding mothers.
◊ Work with community organizations, doctors,
and nurses to create networks that provide
at-home or clinic-based breastfeeding support
for every newborn.
◊ Become Baby-Friendly.
www
http://www.cdc.gov/vitalsigns
www
http://www.cdc.gov/mmwr
CS225478B
For more information, please contact
Telephone: 1-800-CDC-INFO (232-4636)
TTY: 1-888-232-6348
E-mail: [email protected]
4
Web: www.cdc.gov
Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Publication date: 08/02/2011
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