title: Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting.
abstract: OBJECTIVE
  Breastfeeding initiation rates were compared at Boston Medical Center 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, achieved Baby-Friendly status in 1999.
  
  
  METHODS
  Two hundred complete medical records, randomly selected by a computer, 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 substance 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 breast 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 black mothers in this population from 34% (1995) to 64% (1998) to 74% (1999).
  
  
  CONCLUSIONS
  Full implementation of the Ten Steps to Successful Breastfeeding leading to Baby-Friendly designation is an effective strategy to increase breastfeeding initiation rates in the US hospital setting.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts 02118, USA. bobbi.philipp@bmc.org
authors.forename: B L
authors.initials: BL
authors.lastname: Philipp
authors.forename: A
authors.initials: A
authors.lastname: Merewood
authors.forename: L W
authors.initials: LW
authors.lastname: Miller
authors.forename: N
authors.initials: N
authors.lastname: Chawla
authors.forename: M M
authors.initials: MM
authors.lastname: Murphy-Smith
authors.forename: J S
authors.initials: JS
authors.lastname: Gomes
authors.forename: S
authors.initials: S
authors.lastname: Cimo
authors.forename: J T
authors.initials: JT
authors.lastname: Cook
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D001900:Boston; D001942:Breast Feeding / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011050:Policy Making