title: 10 years after baby-friendly designation: breastfeeding rates continue to increase in a US neonatal intensive care unit.
abstract: BACKGROUND
  Mothers of preterm and sick infants admitted to the neonatal intensive care unit (NICU) often encounter more difficulties with breastfeeding than mothers of healthy term newborns. The extent to which Baby-Friendly designation is associated with breastfeeding rates for NICU infants over time is unknown.
  
  
  OBJECTIVE
  This study aimed to determine the rate of breastfeeding initiation and continuation in a US, inner-city, level 3 NICU 10 years after Baby-Friendly designation.
  
  
  METHODS
  We compared the rate of breastfeeding initiation and continuation among breastfeeding-eligible mothers with infants admitted to the Boston Medical Center NICU in 1999 and 2009, using chi-square tests.
  
  
  RESULTS
  Breastfeeding initiation increased from 74% in 1999 to 85% in 2009 (P = .04). Any breast milk at 2 weeks of age increased from 66% to 80% (P = .05), and exclusive breastfeeding at 2 weeks remained stable between 1999 and 2009. Breastfeeding initiation increased from 68% to 86% among black mothers from 1999 to 2009 (P = .01).
  
  
  CONCLUSIONS
  Improvement in breastfeeding initiation and any breastfeeding at 2 weeks of age continued 10 years after Baby-Friendly designation among mothers with NICU infants in a US, inner-city, level 3 NICU.
authors.affiliation: Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA 02118, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Parker
authors.forename: Laura
authors.initials: L
authors.lastname: Burnham
authors.forename: John
authors.initials: J
authors.lastname: Cook
authors.forename: Emily
authors.initials: E
authors.lastname: Sanchez
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Philipp
authors.forename: Anne
authors.initials: A
authors.lastname: Merewood
mesh_terms: D000328:Adult; D001741:Black or African American; D001900:Boston; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data / Q000639:trends*; D002568:Certification; D005260:Female; D006293:Health Promotion; D006784:Hospitals, Teaching / Q000458:organization & administration / Q000706:statistics & numerical data / Q000639:trends; D006786:Hospitals, Urban / Q000458:organization & administration / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D017410:Practice Guidelines as Topic
keywords: Baby-Friendly hospital; breastfeeding; neonatal intensive care unit; preterm infants