Documented In-Hospital Lactation Support and Exclusive Breastfeeding During the Postpartum Stay
Tiffany T Gallagher1, Anne C McKechnie2, Robin R Austin2
1Division of Epidemiology and Community Health, School of Public Health, University of Minnesota Twin Cities, Minneapolis.
JAMA Network Open
|July 24, 2026
Summary
Increased in-hospital breastfeeding support is linked to higher rates of exclusive breastfeeding (EBF). However, disparities in care exist, particularly for minority groups. More support can help reduce breastfeeding outcome gaps.
Area of Science:
- Public Health
- Maternal and Child Health
- Health Services Research
Background:
- Exclusive breastfeeding (EBF) during the postpartum hospital stay is crucial for longer breastfeeding duration.
- Electronic health record (EHR) data can reveal inequities in breastfeeding care and persistent disparities.
- Understanding patterns of care is essential for improving breastfeeding outcomes.
Purpose of the Study:
- To assess the association between documented postpartum in-hospital breastfeeding support and EBF.
- To examine differences in documented care based on feeding intention, demographics, and clinical factors.
- To identify potential disparities in breastfeeding support provision.
Main Methods:
- Cross-sectional study using EHR data from 22,857 mother-infant dyads.
- Analysis of documented lactation support events using the breastfeeding support ratio (BSR).
- Multivariable logistic regression with restricted cubic splines to estimate EBF probability and relative risk (RR) of inadequate support.
Main Results:
- A positive, nonlinear association was found between BSR and EBF probability.
- Inadequate breastfeeding support (BSR < 1.00) was more common among minority racial/ethnic groups, those intending combination feeding, and individuals with specific demographic and clinical characteristics.
- Higher RRs of inadequate support were observed for patients intending combination feeding, needing interpreters, younger than 25, single, publicly insured, with higher BMI, smokers, undergoing C-section, with shorter gestation, and low birth weight infants.
Conclusions:
- Documented in-hospital breastfeeding support frequency positively correlates with EBF during the hospital stay.
- Significant disparities in the documentation and provision of breastfeeding support were identified.
- Increasing in-hospital breastfeeding support beyond current recommendations may help mitigate breastfeeding outcome disparities.
Related Concept Videos
01:31Discharge Summary Forms
The discharge summary is crucial as it enables a smooth transition from a healthcare facility to a patient's home or another care setting. This critical document facilitates seamless continuity of care, ensuring patients receive the necessary support and attention.
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:26Guidelines for Nursing Documentation II
Effective documentation is an integral part of nursing practice. Here are some essential guidelines to follow when documenting patient care:
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
Timely documentation is crucial to ensure continuity of care for patients. Any delays in recording or reporting medical information can result in medical errors and even adverse patient outcomes. From medication administration to diagnostic test results, every detail must be accurately and promptly documented to provide the best possible care for patients.
01:30Guidelines for Nursing Documentation I
Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
Factual:
The following points emphasize the significance of upholding accurate and unbiased documentation in healthcare.
01:30Development of Human Microbiota
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from the skin...
01:28Development of the Oral Microbiota
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities