title: Sustained breastfeeding rates at a US baby-friendly hospital.
abstract: 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.
authors.affiliation: Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts, USA. bobbi.philipp@bmc.org
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Philipp
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Malone
authors.forename: Sabrina
authors.initials: S
authors.lastname: Cimo
authors.forename: Anne
authors.initials: A
authors.lastname: Merewood
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D001900:Boston; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D011181:Postnatal Care / Q000706:statistics & numerical data