Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting

Objective. Breastfeeding initiation rates were compared at Boston Medical C enter before (1995), during (1998), and after (1999) Baby-Friendly policies were in place. Boston Medical Center, an inner-city teaching hospital that provides care primarily to poor, minority, and immigrant families, achieve d Baby-Friendly status in 1999. Methods. Two hundred complete medical records, randomly selected by a compu ter, were reviewed from each of 3 years: 1995, 1998, and 1999. Infants were excluded for medical records missing feeding data, human immunodeficiency virus-positive parent, neonatal intensive care unit admission, maternal sub stance abuse, adoption, incarceration, or hepatitis C-positive mother. All infant feedings during the hospital postpartum stay were tallied, and each infant was categorized into 1 of 4 groups: exclusive breast milk, mostly br east milk, mostly formula, and exclusive formula. Results. Maternal and infant demographics for all 3 years were comparable. The breastfeeding initiation rate increased from 58% (1995) to 77.5% (1998) to 86.5% (1999). Infants exclusively breastfed increased from 5.5% (1995) to 28.5% (1998) to 33.5% (1999). Initiation rates increased among US-born b lack mothers in this population from 34% (1995) to 64% (1998) to 74% (1999) . Conclusions. Full implementation of the Ten Steps to Successful Breastfeedi ng leading to Baby-Friendly designation is an effective strategy to increas e breastfeeding initiation rates in the US hospital setting.