Reported Adherence to the 10 Steps to Successful Breastfeeding Is Higher Among Baby-Friendly Hospitals

Abstract

ObjectiveQuantify and compare reported breastfeeding support practices in the Baby-Friendly Hospital Initiative (BFHI) and non-BFHI facilities. DesignCross-sectional survey. SettingRegions across the US. ParticipantsTwo hundred and eighty-six facilities (110 BFHI and 176 non-BFHI) selected by a stratified (by hospital size) random sample of 50% BFHI and 50% non-BFHI facilities. InterventionEmailed survey Fall 2019 through Spring 2020. Main Outcome MeasureReported adherence to the 10 Steps to Successful Breastfeeding. AnalysisWilcoxon rank sum test with continuity correction, Pearson chi-square test of independence, and Fisher's exact test. ResultsBaby-Friendly Hospital Initiative facilities were more likely to report adherence to the 10 Steps to Successful Breastfeeding. Only 2 of the reported steps were not significantly different: immediate postnatal care and responsive feeding. Conclusions and ImplicationsThis research supports breastfeeding support interventions within hospitals as both BFHI and non-BFHI facilities have room for improvement. Interventions targeting non-BFHI facilities are an opportunity to close the disparity in breastfeeding care.