An evaluation of hospital breastfeeding policies in the Philadelphia metropolitan area 1994-2009: a comparison with the baby-friendly hospital initiative ten steps.
OBJECTIVE
The purpose of this study was to describe current breastfeeding policies and practices among Philadelphia, PA metropolitan hospitals and changes in their policies and practices over time.


METHODS
In-person group interviews were conducted to obtain a composite picture of actual breastfeeding policies and practices. One questionnaire per hospital was completed based on responses from group consensus. Twenty-five hospitals providing maternity care were contacted. Information was obtained from personnel representing different areas of maternity services. Hospitals were classified according to the degree to which they were implementing the Ten Steps to Successful Breastfeeding.


RESULTS
Mean breastfeeding rates at suburban hospitals were significantly higher than urban hospitals (72% vs. 49%, p = 0.015). Most hospitals were classified as high or moderately high implementers on six of the Ten Steps, including staff training (67%), printed information distributed to breastfeeding mothers (94%), breastfeeding initiation (61%), oral breastfeeding instruction given to mothers (83%), infant feeding schedules (89%), and hospital postpartum support (83%). Most hospitals reported partial or low implementation on two maternity practices: infant formula supplementation (61%) and rooming-in (72%).


CONCLUSIONS
In the past 15 years, hospitals in the Philadelphia area have an increased awareness about breastfeeding and enhanced support of breastfeeding by healthcare professionals. In spite of an increase in overall breastfeeding rates, formula supplementation in hospitals and contact time between mothers and their newborns continue to be areas of concern.
Department of Medical Science and Community Health, Arcadia University, Glenside, Pennsylvania 19038, USA. crivella@arcadia.edu
Andrea
A
Crivelli-Kovach
Esther K
EK
Chung
D001942:Breast Feeding / Q000453:epidemiology*; D037001:Directive Counseling; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006293:Health Promotion; D006771:Hospitals, Maternity / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D041943:Infant Formula / Q000706:statistics & numerical data; D007231:Infant, Newborn; D033181:Information Dissemination; D007407:Interviews as Topic; D016134:Organizational Policy; D010351:Patient Discharge / Q000592:standards; D015143:Philadelphia / Q000453:epidemiology; D011181:Postnatal Care / Q000592:standards / Q000706:statistics & numerical data; D011247:Pregnancy; D012386:Rooming-in Care / Q000592:standards / Q000706:statistics & numerical data; D013192:Staff Development; D011795:Surveys and Questionnaires