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The Breastfeeding Coalition of Washington (BCW) and the Washington State Department of Health track data to show breastfeeding trends in a variety of settings. BCW Manager Rachel Schwartz notes that, while most babies in WA State start out life breastfeeding, our rates of breastfeeding exclusivity and duration have room for improvement. “The percentage of mothers who breastfeed who also supplement with formula is on the rise” she says, “so that one in five breastfed babies have received formula by day two of life.”
There are several state and national data sources that breastfeeding advocates track to assess breastfeeding initiation, exclusivity and duration rates. This includes survey data from the US Centers for Disease Control and Prevention such as the National Immunization Survey, Pregnancy Risk Assessment Monitoring System (PRAMS) data, the annual Breastfeeding Report Card, and results from the Maternity Practices in Infant Nutrition and Care (mPINC) survey, which evaluates states and hospitals according to their success at implementing the Ten Steps to Successful Breastfeeding.
The CDC’s National Immunization Survey shows that 88% of mothers initiate breastfeeding with their infants in Washington State, which is higher than the national average of 75%. Data also shows that 60% of mothers in the state continued to breastfeed their infants at six months, although exclusive rates of breastfeeding at six months are below the Healthy People 2020 goal.
For low income women, the Women, Infants and Children Nutrition Support Program (WIC) evaluates the initiation of breastfeeding among women enrolled in the program. Data from 2010 show that more than 85% of WIC mothers breastfed their infants, an increase of more than 15% in ten years. Not only do these data show the success of WIC education initiatives, they also show that the breastfeeding rate of WIC clients is rapidly approaching that of all mothers in the state.
In 2010, the BCW worked with Martha Shanahan, MPH, RD, to conduct a qualitative evaluation of their Maternity Care Practices Initiative pilot project with Yakima Valley Memorial Hospital. The project “Improving Breastfeeding Rates through Maternity Care Practices” aimed to ensure evidence-based hospital maternity care and infant feeding. Shanahan conducted an evaluation of a four hour training session for maternity care nurses and showed that the ongoing education is having a notable impact. Participants reported that the training increased their understanding of evidenced-based research regarding maternity care practices and breastfeeding. They have also seen changes in practice and policy at the hospital.
The Coalition also commissioned a 2010 study called “Evaluation of Breast Pumping Rooms Placed in Fruit Packing Facilities in North Central Washington.” The study revisited 10 fruit packing warehouses throughout Chelan, Douglas and Okanogan Counties where breast pumps and mini refrigerators were placed for employee use, thanks to a grant from the State WIC Program in 2005. The author of the study, Laurie Riegert, MPH, RD, found that seven of the pumps were still available for use after five years. After recruiting interviewees through nearby WIC offices, Riegert found that employees mainly used breast pumps on loan to them from their local WIC offices. The majority of women reported a good experience with pumping, but some felt that improvements were needed, such as more break time and a more comfortable place to pump, as well as more support from their employers.
As patient information increasingly converts to electronic records, Schwartz anticipates that hospitals will have more capacity for evaluating breastfeeding initiation and exclusivity during the hospital stay. Changes in reporting to hospital accreditors will also have an impact on tracking exclusive breastfeeding. In 2010, the Joint Commission, which is the accreditation body for the majority of hospitals in WA, adopted a new Perinatal Care Core Measure set, which includes tracking exclusive breastfeeding. Schwartz looks forward to supporting hospitals as they adopt this new measure. “We know that a substantial percentage of supplementation of breastfed babies in the hospital is not medically indicated. The new Core Measure should help hospitals keep better track of why babies are being supplemented with formula and will give hospitals the data and tools to ensure they are providing optimal infant nutrition.”
Featured: September 2011
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