Breastfeeding practices in New York State maternity hospitals: results from a statewide survey

This study characterized maternity hospital breastfeeding practices in New York.

The New York State Department of Health Breastfeeding Survey was sent to 138 hospitals providing maternity services to assess breastfeeding and rooming-in policies, infant feeding practices, breastfeeding training, staff structure, and support mechanisms. Additionally, hospital-specific exclusive breastfeeding rates were obtained from Hospital Profile data.

The response rate was 100%. Ninety-three percent of the hospitals allowed 24-hour rooming-in, in all postpartum rooms. Eighty-six percent of hospitals employed a designated lactation coordinator. Less than 1.5% of hospitals routinely gave formula, pacifiers, or glucose water to a breastfed infant. These supplements are most commonly provided because of the mother's request. The largest reported barrier to initiating breastfeeding in the hospital was presenting mothers with mixed messages, whereas the largest patient barrier was identified as the mother's culture. All hospitals provided obstetric nursing staff with lactation education, whereas 46.4% trained physicians. Among healthy births, exclusive breastfeeding was statistically more likely to occur in hospitals offering only basic care (Level I) or subspecialty care (Level III), relative to Regional Perinatal Centers delivering the highest level of care, and was more likely with hospitals outside of New York City, relative to those within the city. After controlling for hospital location and level of care, exclusive breastfeeding was statistically more likely in hospitals that initiate breastfeeding immediately following an uncomplicated vaginal or cesarean birth.

Mothers should be encouraged to initiate breastfeeding immediately after birth. Practices of Level I hospitals that lead to increased breastfeeding should be identified.