Breastfeeding takes a lot of work. It takes a lot of time and energy, and you need a lot of support from those around you in order to succeed, even if you fully intend to breastfeed your baby.
The World Health Organization and UNICEF started the Baby-Friendly Hospital Initiative in 1991 to standardize the evidence-based practices to support parents as they start breastfeeding in the birth hospital. These practices include rooming-in, helping mothers initiate breastfeeding within 1 hour of birth, encouraging breastfeeding on demand, and giving infants no food or drink other than human milk, unless medically indicated.
It is fairly well-established from prior studies that mothers who give birth at a hospital with a Baby-Friendly designation are more likely to initiate and continue breastfeeding. Is this true for mothers with low income, who may lack breastfeeding role models and/or support for breastfeeding in both the home and work environments?
This week, Pediatrics is early releasing an article by a team from the Centers for Disease Control and Prevention, led by Dr. Jennifer Beauregard, entitled “Maternity Care Practices and Breastfeeding Intentions at One Month Among Low-Income Women” (10.1542/peds.2021-052561). This article uses data from a recent national survey of mothers who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Because WIC eligibility is based on family income, all WIC recipients can be considered to have low income.
The authors wanted to see if specific Baby-Friendly hospital practices were associated with exclusive breastfeeding at 1 month of age in the subgroup of women who were low-income and intended to exclusively breastfeed their infant for at least 1 month.
While you should definitely read the entire article to get the other details, there are 2 results that you should be aware of:
- The more Baby-Friendly practices that a mother was exposed to, the more likely she was to be meet her intention of exclusively breastfeeding at 1 month.
- Starting breastfeeding within 1 hour of birth and giving the infant no food or drink other than human milk in the hospital were the two practices that were associated with the mother meeting her intention of exclusive breastfeeding at 1 month.
These two specific practices send the message that breastfeeding is important and the best food for the baby. For some mothers, this may be the first time that they hear these messages. Both of these practices require additional support from the hospital staff in the form of teaching the mother that cluster feeding in the first 48 hours is normal, monitoring the mother-infant dyad more closely, and reinforcing that the baby is doing what they’re supposed to be doing. I suspect that this extra teaching, monitoring, and reinforcement may give the new mother a little more confidence in her capacity to offer human milk for her baby, if she chooses and is able.