'Baby-Friendly' Hospitals Up Breastfeeding Rates

NEW YORK (Reuters Health) - Women who give birth at U.S. hospitals and birthing centers with a "Baby-Friendly" designation are more likely than other women to start breastfeeding, a new study shows.

The findings, published in the journal Pediatrics, are good news for Baby-Friendly centers, which are designated as such because they actively encourage women to breastfeed. The centers are part of a global program sponsored by the World Health Organization and United Nations that has laid out specific steps for hospitals and birthing centers to take in order to promote breastfeeding.

In the U.S., centers are deemed Baby-Friendly if they take 10 steps, which include helping all new mothers start breastfeeding within an hour of delivery, allowing mothers and infants to stay in the same room at all times, and giving newborns no food other than breast milk, unless medically necessary.

The new study looked at breastfeeding rates in 2001 at 29 U.S. hospitals and birthing centers that had a Baby-Friendly designation. On average, researchers found, 84 percent of new mothers at the centers started breastfeeding during their stay -- versus the national rate of 69.5 percent -- and most centers surpassed the breastfeeding-initiation rates for their local regions.

The researchers are from Boston University School of Medicine and Boston Medical Center, one of the now 50 Baby-Friendly centers in the U.S.

The global Baby-Friendly program, begun in 1991, has been slow to catch on in the U.S., but interest has been picking up a bit in recent years, according to lead study author Anne Merewood, a lactation consultant and assistant professor of pediatrics at Boston University.

The fact that the initiative is proving successful may encourage other hospitals and birthing centers to take it up, Merewood said in an interview.

Breast milk is considered the best nutrition for infants, with studies documenting numerous benefits, including a lower risk of diarrhea, ear and respiratory infections, and allergies. Mothers, too, may reap health benefits, such as a quicker return to their pre-pregnancy weight and a lower risk of breast and ovarian cancers later in life.

Experts generally recommend that babies be exclusively breastfed for the first 6 months of life.

While the findings reinforce the value of Baby-Friendly program centers, Merewood said, the study did find that hospitals face some obstacles in setting up the 10-step policy.

The top challenge, cited by nine hospitals, was the cost of buying infant formula, which must be on hand for newborns who need it.

Typically, formula manufacturers give hospitals free formula, which they can then offer free to parents to take home -- a "clever" tactic, Merewood noted, that encourages bottle-feeding. But because Baby-Friendly hospitals do not, as a matter of policy, provide free formula or bottles to parents, they must pay for the formula they keep on hand.

Another obstacle is simply getting centers and staff to "change entrenched routines," Merewood said. Birthing centers in the study seemed to have an easier time of it than hospitals, with some reporting that all new mothers started breastfeeding during their stay.

It is easier to implement Baby-Friendly policies at birthing centers, Merewood noted, simply because they are small and have fewer high-risk births.

SOURCE: Pediatrics, September 2005.