title: Availability of lactation counseling services influences breastfeeding among infants admitted to to neonatal intensive care units.
abstract: OBJECTIVE
  To assess the association between the presence of international board-certified lactation consultant (IBCLC) services at a delivery hospital and the breastfeeding practices of women whose infants required neonatal intensive care unit (NICU) admission.
  
  
  METHODS
  Cross-sectional study using population-level data.
  
  
  METHODS
  Philadelphia, Pennsylvania.
  
  
  METHODS
  2132 infants admitted to the NICU.
  
  
  METHODS
  Breastfeeding at hospital discharge was measured with the question, "Is the infant being breastfed?" Delivery hospitals were dichotomized as to the presence or absence of an IBCLC on staff
  
  
  METHODS
  Logistic regression was used to assess the relationship between breastfeeding at discharge and the presence of an IBCLC at the delivery facility while adjusting for maternal characteristics and birth outcomes.
  
  
  RESULTS
  Among mothers of infants admitted to the NICU, breastfeeding rates among mothers who delivered at hospitals with an IBCLC were nearly 50% compared with 36.9% among mothers who delivered at hospitals without an IBCLC. The adjusted odds of breastfeeding initiation prior to hospital discharge were 1.34 (95% confidence interval = 1.03, 1.76) times higher for women who delivered at a facility with an IBCLC.
  
  
  CONCLUSIONS
  To increase breastfeeding rates among the NICU population, these findings support the need for universal availability of IBCLCs at delivery facilities that have NICUs.
authors.affiliation: Texas Department of State Health Services, Austin, TX 78613, USA. brian.castrucci@dshs.state.tx.us
authors.forename: Brian C
authors.initials: BC
authors.lastname: Castrucci
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Hoover
authors.forename: Suet
authors.initials: S
authors.lastname: Lim
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Maus
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006771:Hospitals, Maternity; D006786:Hospitals, Urban / Q000458:organization & administration*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration* / Q000706:statistics & numerical data; D007774:Lactation / Q000502:physiology; D016015:Logistic Models; D016134:Organizational Policy; D010353:Patient Education as Topic; D015143:Philadelphia; D012944:Social Support