Baby Friendly Hospital Designation and Breastfeeding Outcomes Among Maryland WIC Participants.

Abstract

The Baby-Friendly HospitalInitiative is an effective intervention to support maternal practices around breastfeeding. However, little is known about its impact on participants of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). The purpose of this study was to evaluate whether Baby Friendly Hospital (BFH) designation in Maryland improved breastfeeding practices among Special Supplemental Nutrition Program forWomen, Infants and Children (WIC) participants. Breastfeeding practices of WIC participants (22,543 mother-infant dyads) were analyzed utilizing WIC management information system de-identified data from four Maryland WIC agencies during 2010-12 and 2017-19. Participants lived in areas served by a hospital that became BFH in 2016 or remainednon-BFH. Pre-post implementation breastfeeding practices (breastfeeding initiation, at 3months and 6months) of women associated with a BFH were compared to women associated with a non-BFH usingpropensity score weighting and a difference-in-difference modeling. From pre to post interventionno differences in breastfeeding initiation or any breastfeeding at 6 months were attributable to BFH status. There was some evidence that BFH designation in 2016 was associated with an absolute percent change of 2.4% (P=0.09) for any breastfeeding at 3months. Few differences in breastfeeding outcomes among WIC participants were attributable to delivery in a BFH.Results from this study inform policy about maternity practices impacting WIC breastfeeding outcomes. More study needed to determine the impact of BFH delivery on differences in breastfeeding outcomes between sub-groups of women.