title: Hospital-wide breastfeeding rates vs. breastmilk provision for very-low-birth-weight infants.
abstract: OBJECTIVE
  To investigate the relationship between breastmilk feeding in very-low-birth-weight infants in the neonatal intensive care unit and breastmilk feeding rates for all newborns by hospital.
  
  
  METHODS
  This was a cross-sectional study of 111 California hospitals in 2007 and 2008. Correlation coefficients were calculated between overall hospital breastfeeding rates and breastmilk feeding rates of very-low-birth-weight infants. Hospitals were categorized in quartiles by crude and adjusted very-low-birth-weight infant rates to compare rankings between measures.
  
  
  RESULTS
  Correlation between breastmilk feeding rates of very-low-birth-weight infants and overall breastfeeding rates varied by neonatal intensive care unit level of care from 0.13 for intermediate hospitals to 0.48 for regional hospitals. For hospitals categorized in the top quartile according to overall breastfeeding rate, only 46% were in the top quartile for both crude and adjusted very-low-birth-weight infant rates. On the other hand, when considering the lowest quartile for overall breastfeeding hospitals, three of 27 (11%) actually were performing in the top quartile of performance for very-low-birth-weight infant rates.
  
  
  CONCLUSIONS
  Reporting hospital overall breastfeeding rates and neonatal intensive care unit breastmilk provision rates separately may give an incomplete picture of quality of care.
authors.affiliation: Department of Pediatrics, Stanford University, 750 Welch Road, Palo Alto, CA 94304, USA. hclee@stanford.edu
authors.forename: Henry C
authors.initials: HC
authors.lastname: Lee
authors.forename: Priya
authors.initials: P
authors.lastname: Jegatheesan
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Gould
authors.forename: Raymond A
authors.initials: RA
authors.lastname: Dudley
mesh_terms: D001903:Bottle Feeding / Q000706:statistics & numerical data*; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002140:California; D003430:Cross-Sectional Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007228:Infant Nutrition Disorders / Q000517:prevention & control*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D019102:Infant, Very Low Birth Weight; D015931:Intensive Care, Neonatal; D008895:Milk, Human