Sustained breastfeeding rates at a US baby-friendly hospital

Objective. Boston Medical Center (BMC) became the 22nd US Baby-Friendly hospital in 1999. Previous research found that breastfeeding initiation rates increased significantly from 58% in 1995 to 86.5% in 1999. The objective of this study was to establish whether Baby-Friendly status would sustain elevated breastfeeding initiation rates at this US hospital beyond the year of designation. Breastfeeding rates in 1999 were compared with rates in 2000 and 2001. Methods. A total of 200 medical records of full-term, healthy infants who were born at BMC in 2000 and 2001 were reviewed using the same criteria as the study conducted for 1999. Records were selected randomly by a computer-generated list. All infant feedings during the hospital postpartum stay were tallied, and each infant was categorized into 1 of 4 groups: 1) exclusive breast milk, 2) mostly breast milk, 3) mostly formula, and 4) exclusive formula. Results. Maternal and infant demographics for all 3 years were comparable. The breastfeeding initiation rates, defined as an infant's receiving any amount of breast milk, remained at high levels: 87% ( 1999), 82% ( 2000), and 87% ( 2001). Infants who received more breast milk than formula also was sustained: 73% ( 1999), 67% ( 2000), and 67% ( 2001). Infants who were breastfed exclusively across the 4 years did not differ significantly: 34% ( 1999), 26% ( 2000), and 25% ( 2001). Conclusions. Full implementation and continued application of the Ten Steps to Successful Breastfeeding, the framework of the Baby-Friendly Hospital Initiative, has an extended positive impact on breastfeeding rates in a US hospital setting.