Hospitals need to do more to help moms breastfeed
August 3rd, 2011
12:55 PM ET

Hospitals need to do more to help moms breastfeed

Hospitals could and should do a lot more to help women succeed at breastfeeding, according to a new report released by the Centers for Disease Control and Prevention.

"Hospitals need to greatly improve practices to support mothers who want to breastfeed," says Dr. Thomas Frieden, the CDC's director. "If they don't, at current trends, it will take more than 100 years before every baby in this country is born in a hospital where the hospital fully supports a mother's desire to breastfeed." Hospitals are encouraged to practice "Ten Steps to Successful Breastfeeding," which are based on recommendations from the World Health Organization and UNICEF. However, less than 4% of hospitals provide the necessary support based on these recommendations, according to the CDC report.

A new mother's ability to continue  breastfeeding is influenced by what she  experiences and how much support she receives during the first hours and days after birth. Breast milk is "the perfect nutrition," says Frieden. It provides antibodies to help newborns ward off illness until the immune system can produce their own, which doesn't happen until the infant is 6 months old.  Mom's milk also provides important hormones that help baby regulate how much it needs to eat. Plus, studies have shown that breastfeeding reduces diarrhea, ear infections and bacterial meningitis, as well as cutting the risk of sudden infant death syndrome, diabetes and asthma, according to the American Academy of Pediatrics.

The CDC report says breastfeeding for nine months reduces a baby's odds of becoming overweight by more than 30%. For babies to get all of these benefits, the AAP recommends that infants should be fed only breast milk for the first six months of life and moms should continue to nurse while they start introducing solid foods until the baby is at least a year old, longer if mom and baby still want to.

Mothers also benefit from breastfeeding. Nursing burns calories. Moms could lose up to two pounds a month according to the AAP. It also helps the uterus contract and return to its normal size.  Studies suggest that women who breast feed have lower rates of ovarian and breast cancer later in life.

It also has some practical benefits. Baby's food supply is always on hand and it's free. Plus, a healthier baby reduces health care costs: "Failure to ensure breastfeeding or promote breastfeeding costs us $2.2 billion every year," says Frieden. And yet, according to the CDC's latest data, although most U.S. women – about 80% –  say before delivery that they intend to breastfeed, and 75% start breastfeeding, by the time the baby is 1 week old,  half of women have already given the baby formula. By the time the babies are 9 months old, only 31% are breastfeeding at all. In the United States, only 14% of women exclusively breastfeed their children for 6 months and less than half nurse their babies at all during the first 6 months.

While breastfeeding is a very natural thing – women have been doing it for thousands of years – it takes a little while for mom and baby to figure out how it works. Prenatal classes may have taught parents how to hold the baby while nursing, but getting baby to properly latch on can be challenging.  In some cases it doesn't work and then feeding the baby formula may become medically necessary. However, in most cases, with a little help and encouragement, moms can successfully nurse their newborns and get on the path of breastfeeding for a longer period of time.

This is where hospitals could do more according to the CDC. If all of the 10 "baby-friendly" recommendations were followed, mothers might be more successful at nursing.

* For example, despite the recommendation that mothers should exclusively breastfeed their newborns, nearly 80% of hospitals were giving babies formula, water or sugar-water, even though there was no medical reason to supplement their nutrition. Frieden says for many hospitals it's just routine to give every baby formula. New moms are also given gift bags with free formula when they leave the hospital, which sends a mixed message to new parents trying to breastfeed.

* Newborns should be placed on the mother's breast within the first hour after birth because the skin-to-skin contact helps mom and baby initiate the nursing process. Yet only half of all hospitals helped new moms do this.

* Only one-third of hospitals allow mother and child to stay in the same room. It's much easier to nurse every 1-to-2 hours if the baby is in the same room.

* Nearly 75% of hospitals do not provide breastfeeding support for families after they leave the hospital. Moms usually stay in the hospital for only a few days, and difficulties with nursing can crop up days and weeks later. Perceptions of not producing enough milk or infants having difficulty nursing are often cited as reasons for mothers who abandon breastfeeding. Follow-up calls from the hospitals and connecting new moms with support groups could encourage mothers to stick to it. Cria Perrine Ph.D., a CDC epidemiologist and one of the authors of the report, says her agency data indicate that when hospitals follow the baby-friendly guidelines their costs do not increase.

In response to this report, the American Hospital Association tells CNN: "Breastfeeding is a personal choice and hospitals will follow the wishes of the mother, be it to breastfeed or bottle feed. There are numerous reasons for the results and those include that hospitals can’t always accommodate a single room for maternity care and some mothers choose to send their babies to the nursery."

There are of course other ways to help mothers continue to breastfeed. One came earlier this week, when the Department of Health and Human Services adopted recommendations from the Institute of Medicine, which will require insurance companies to pay for breastfeeding support, supplies and counseling, without any cost to the insured (aside from her regular insurance premiums of course), starting in August 2012.

Mothers-to-be can also be proactive by checking out the hospital where they plan to deliver and ask about the programs in place to support the desire to nurse.  They can also inform and remind any and all hospital personnel that they want to have their baby on their breast within the first  hour after birth. Dads can help by reinforcing that this happens after the baby is born.  Once mom and baby are settled in their room, they can continue to advocate for themselves by letting the nurses know that they don't want their babies fed without their permission.

Providing accommodations and time for mothers to pump their breast milk when they return to work is also essential to women successfully continuing to breastfeed.  It helps them maintain their milk production and allows their babies to be bottle-fed with breast milk while mom is at work.  Lawmakers from Oregon and New York introduced legislation on Tuesday to expand the breastfeeding provision of the Fair Labor Standards Act to cover salaried office workers.  It already covers non-exempt employees.  Employers are supposed to provide employees with reasonable break times to pump their milk in a non-bathroom environment.  The legislation in both states also aims to protect women from being fired or being discriminated against for taking breaks to express their milk.

soundoff (104 Responses)
  1. Shell

    I read this entire article and most of the comments and I'm surprised nobody is mentioning a driving factor for a lot of moms to stop breastfeeding after a few weeks/months and switch to formula. How many women out there used to smoke and drink before getting pregnant? They quit for 9 months, maybe breastfeed for a while, but want to go back to drinking and/or smoking. And in those cases, obviously it is better for the baby to be switched to formula. I agree that new moms need support if they want to breastfeed. But the reality is, clean formula is healthier than breast milk tainted with alcohol, drugs, and tobacco.

    August 20, 2011 at 22:23 | Report abuse | Reply
    • Alison

      Shell- I am sorry but I completely disagree with you. The breastfeeding mothers that I know all quit because of having to return to work and not having the time and/or space at work to pump in order to continue breastfeeding. In my case, my son would not latch on and ended up in the NICU from not eating. Not once did a nurse ask about the breastfeeding, offer a bottle, or get me a consultation with a lactation specialist.....all of which would have avoided his near death experience and costly stay in the NICU. For fear of running into problems once I returned home, I did not continue breastfeeding. I am not sure where you live, and perhaps there is more substance abuse in your area, but where I live on the East Coast substance use is not a primary reason why mothers would quit breastfeeding.

      August 31, 2011 at 16:51 | Report abuse |
  2. AnnaBF

    This is a perfect example of American policy being completely disconnected from nature. With and infant death rate that is in 41st position out of 45 industrialized countries and a 30% cesarean rate, maybe we should wake up and take notice. We distance ourselves from nature from the day a child is born in the name of what is financially beneficial for hospitals, government, and corporations. We don't put our priorities into creating healthy children, healthy families, and, in turn, healthy adults. Our maternity care in hospitals and maternity leave policies are shameful. It is no wonder that babies are not getting the nutrition that nature intended for them when moms aren't getting any support. Babies are just part of the money making wheel that the rest of us are on. We need to seriously look at our priorities as a culture when we fail our children like this. This is just another really sad symptom of a global disconnection from nature, from the natural system that connects each of us in a mutual guarantee that we will each receive what we need to live an optimum life.

    September 1, 2011 at 01:50 | Report abuse | Reply
    • Cheryl

      Our community had several breast feeding education centers for low income mothers which lost funding several years ago, however, there is still an active La Leche League. Now is the time for everyone to cooperate. There is no need for this natural information to be held captive by hosipitals and insurance companies. Hospitals just need to allow these community breast feeding groups to bring their volunteers to the women having babies. Cooperation and mutual problem solving will become the the only way we can get these tasks underweigh and we just need to allow this kind of volunteerism. Everything is possible with cooperation and its free.

      September 1, 2011 at 02:20 | Report abuse |
  3. Lyn

    I cannot believe the American Hospital Association would take such a stance on breastfeeding, with what we not know about its impact on creating healthier communities. Come on guys!!! Smoking is a choice, too, but we don't' allow it in our hospitals. I am so proud to work in a hospital that offers lactation support to every mother, and has an awesome nursing staff to provide around the clock breastfeeding support here in North Carolina.

    September 16, 2011 at 00:29 | Report abuse | Reply
  4. bernard xuereb

    Whats the big deal ,I'm 80 years old ,i breast fed till i was three and a half ,My mother even showed me theeth marks on her breast when i was older.Good for them.Bernard

    May 11, 2012 at 19:39 | Report abuse | Reply
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