Breastfeeding Supportive Hospital Practices in the US Differ by County Urbanization Level

Area of Science:

• Public Health
• Maternal and Child Health
• Healthcare Disparities

Background:

• Breastfeeding initiation and duration are lower in rural US infants.
• Limited data exist on rural vs. urban hospital differences in breastfeeding support.
• Hospital maternity care practices significantly influence infant feeding outcomes.

Purpose of the Study:

• To determine if maternity care practices supporting breastfeeding differ based on hospital location's level of urbanization.
• To identify specific areas where rural hospitals may lag in providing breastfeeding-supportive care.

Main Methods:

• Linked 2007, 2009, 2011 Maternity Practices in Infant Nutrition and Care (mPINC) survey data.
• Categorized hospital counties using Rural-Urban Continuum Codes (metropolitan urbanized, nonmetropolitan urbanized, less urbanized, thinly populated).

Main Results:

• Average hospital mPINC scores improved from 2007-2011 across all areas.
• Scores were lowest in thinly populated (2007, 2009) and less urbanized (2011) counties.
• Less urbanized hospitals scored significantly lower in breastfeeding assistance, staff training, and care organization compared to urban hospitals.

Conclusions:

• A gap exists in hospital maternity care practices supportive of breastfeeding, influenced by population density.
• Targeted interventions for rural hospitals are crucial to reduce disparities in breastfeeding support.
• Improving rural hospital practices can enhance breastfeeding rates and support nationwide.