1. Amy Le

2.  Breast milk is the best source of nutrition for young children  Provides both short and long-term health benefits for young children

3.  The World Health Organization and American Academy of Pediatrics recommend mothers to exclusively breastfeed for the first 6 months of the infant’s life. ◦ Breast milk, medication or micronutrient supplements are acceptable ◦ Other liquids or solids are not acceptable  Overall, breastfeeding initiation rates in the United States have been increasing but only ◦ 35% of infants were breastfed for 3 months ◦ 15% of infants were breastfed for the recommended 6 months

4.  Most mothers in the United States do not meet recommendations for exclusive breastfeeding  Not much is known about how long mothers plan to exclusively breastfeed  In addition, not much is known about how hospital practices affect plan on exclusively breastfeeding

5.  About 80% of US women intend on breastfeeding ◦ Not much is known about the intended duration  The reasoning behind the low prevalence of continuous exclusive breastfeeding is unclear ◦ Work? ◦ Lack of resources? ◦ Myths?

6.  1) To describe mothers’ exclusive breastfeeding goals  2) To determine if Baby-Friendly practices are associated with these goals.

7.  This study is based on the 1991 Baby- Friendly Hospital Initiative. ◦ Outlines 10 steps hospitals should implement to support breastfeeding ◦ Developed by the World Health Organization and the United Nations Children’s Fund  Hypothesis: Mothers are more likely to achieve their exclusive breastfeeding duration goal when infants are not supplemented in the hospital.

8.  Analyzed data from Infant Feeding Practices Study II ◦ Longitudinal survey of US mothers ◦ Healthy status ◦ Conducted from 2005-2007  Women were recruited in their third trimester of pregnancy via consumer opinion-mail panel.

9.  Eligibility: ◦ Mothers must be at least 18 years old ◦ Mother and infant without any medical conditions that would affect feeding ◦ Infant must be born after 35 weeks gestation ◦ Infant must weigh at least 5 pounds

10.  Each participant was mailed 1 prenatal and 10 postnatal questionnaires about every month  Questionnaires addressed various infant-feeding and care practices  Example: ◦ “What method do you plan to use to feed your new baby in the first two weeks?” ◦ Classification:  “Breastfeed only” – exclusively breastfeeding  “Formula-feed only”  “both breast and formula feed”  “don’t know yet”

11. Majority of women in this study: 25-34 years old White Married Some education past high school 1/3 participate in WIC Program

12. More than 85% of mothers intended to exclusively breastfeed for at least 3 months 57.8% of mothers intended to exclusively breastfeed for at least 5 months.

13. Married mothers that were multiparous (having more than one child) are more likely to meet breastfeeding goal. Mothers that were obese, smoker and longer intended duration were less likely to meet goal.

14.  Mothers often stay 2 days in the hospital.  This time is critical for exclusive breastfeeding establishment.  Important to start breastfeeding early.  Mothers who want to exclusively breastfeed are encouraged to do so.

15.  Friendly hospital practices example: ◦ Giving only breast milk in the hospital may help mothers reach their exclusive breastfeeding goal.  Increased implementation of Baby-Friendly hospital practices may continue to help mothers exclusively breastfeed

16.  Limitations: Lack of diversity  The majority of questionnaire participants were white, married and had some education  Examine the low prevalence of continuous exclusive breastfeeding in more reigons  Should address the specifics of Baby-Friendly Hospital initiative steps ◦ Which steps need improvement? ◦ Which steps work best? ◦ Which steps need to be removed? ◦ Etc.