Work

A dose–response relationship found between the Ten Steps to Successful Breastfeeding indicators and in‐hospital exclusive breastfeeding in US hospitals

Year: 2023

Type: article

Abstract: BACKGROUND: In-hospital exclusive breastfeeding (EBF) is associated with longer breastfeeding durations, yet only 64% of US newborns are EBF for 7 days. The Ten Steps to Successful Breastfeeding (Ten Steps) are a set of evidenced-based maternity practices shown to improve breastfeeding outcomes; these were updated in 2018. METHODS: Using hospital-level data from the 2018 Maternity Practices in Infant Nutrition and Care Survey (n = 2045 hospitals), we examined the prevalence of implementation of Ten Steps indicators (each step and total number of steps implemented). Using linear regression, we also examined the association between the steps and EBF prevalence adjusted for hospital characteristics and all other steps. Discharge support was not included in the models since it primarily occurs after hospital discharge. RESULTS: The most frequently implemented step was the provision of prenatal breastfeeding education (95.6%). Steps with low implementation included rooming-in (18.9%), facility policies supportive of breastfeeding (23.4%), and limited formula supplementation (28.2%). After adjusting for hospital characteristics and all other steps, limited formula supplementation (difference = 14.4: 95% confidence interval [CI]: 12.6, 16.1), prenatal breastfeeding education (difference = 7.0; 95% CI: 3.3, 10.8), responsive feeding (difference = 6.3; 95% CI: 3.7, 9.0), care right after birth (skin-to-skin; difference = 5.8; 95% CI: 4.2, 7.4), and rooming-in (difference = 2.4; 95% CI: 0.4, 4.6) were associated with higher in-hospital EBF prevalence. We found a dose-response relationship between the number of steps implemented and in-hospital EBF prevalence. CONCLUSION: Increased implementation of the updated Ten Steps may improve EBF and infant and maternal health outcomes.

Source: Birth

DOI: 10.1111/birt.12742

Authors: Larelle H. Bookhart, Erica H. Anstey, Michael R. Kramer, Cria G. Perrine, Usha Ramakrishnan, Melissa F. Young

Institutions: Emory University, University of Illinois Chicago, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion

Language: English

Topic: Breastfeeding Practices and Influences

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: Emory University, Centers for Disease Control and Prevention, Health Resources and Services Administration