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- Definition: Percent of newborns fed breast milk during their hospitalization, by mother's county of residence. "Any Breastfeeding" includes infants who breastfeed exclusively and those who breastfeed and receive formula. "Exclusive Breastfeeding" includes those who only breastfeed.Number of newborns fed breast milk during their hospitalization, by mother's county of residence. "Any Breastfeeding" includes infants who breastfeed exclusively and those who breastfeed and receive formula. "Exclusive Breastfeeding" includes those who only breastfeed.
- Data Source: California Department of Public Health, Center for Family Health, Genetic Disease Screening Program, Newborn Screening Data, 2000-2011. Accessed at: http://www.cdph.ca.gov/data/statistics/Pages/BreastfeedingStatistics.aspx (May 2013).
- Footnote: Data for 2010 and 2011 should not be compared with earlier years due to a change in data collection methods. The California Department of Public Health provides margins of error because the forms used to collect these data are not always complete. In 2011, the margin of error at the 95% confidence level for the percentage of California infants with any breastfeeding was +/-0.1 and breastfeeding exclusively was +/-0.3. Margins of error for individual counties were larger. LNE (Low Number Event) refers to data that have been suppressed. Numbers were suppressed if there were fewer than 5 cases; percentages were suppressed if there were fewer than 20 cases.
- Low Birthweight and Preterm Births
- Prenatal Care
- Teen Births
- Why This Topic Is Important
Breast milk is widely acknowledged as the most complete form of nutrition for infants, with a range of benefits for infant health, growth, and development (1). Infants who are breastfed receive protection from serious health conditions, including respiratory, ear, and gastrointestinal tract infections, allergies, diabetes, obesity, and cancer (1). Studies indicate that breastfeeding can reduce the incidence of Sudden Infant Death Syndrome (SIDS), when compared to formula feeding (1). Breastfeeding also offers multiple health advantages to mothers, such as reducing the risk of breast and ovarian cancer, diabetes, and cardiovascular disease (1). Increasing the proportion of children who are breastfed for at least the first year of life -- as well as the percentage who are breastfed exclusively for the first six months -- are important public health goals (1).
Not all women should breastfeed, however. Breastfeeding is not recommended for women who use certain prescription drugs, test positive for HIV, or have active, untreated tuberculosis (1).
California has a statewide goal to make breastfeeding the normal method of infant feeding for at least the first year of life (2). Healthy People 2020, an initiative of the U.S. government that sets national public health goals, set breastfeeding objectives for 46% of infants to be exclusively breastfed through three months old, 26% exclusively breastfed through six months old, and 34% breastfed (along with complementary foods) at one year old (3).
For more information on breastfeeding, see kidsdata.org’s Research & Links section.
Sources for this narrative:
1. American Academy of Pediatrics. (2012). Policy statement: Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-841. Retrieved from: http://pediatrics.aappublications.org/content/early/2012/02/22/peds.2011-3552.full.pdf+html
2. California Department of Health Services: Maternal, Child and Adolescent Health Branch. (2010). Breastfeeding fact sheet. Retrieved from: http://www.cdph.ca.gov/programs/breastfeeding/Pages/default.aspx
3. HealthyPeople.gov. (2011). Maternal, infant, and child health: Infant care. Retrieved from: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26
- How Children Are Faring
In 2011, about 61% of California infants were exclusively breastfed in the hospital after birth, up from 57% in 2010. At the county level, figures ranged from 23% to 89% in 2011. Statewide, white infants continue to have the highest percentages of exclusive breastfeeding (76% in 2011) compared to infants of other racial/ethnic groups.
- Policy Implications
While data have shown that 75% of U.S. mothers start out breastfeeding, only 13% of babies are exclusively breastfed at the end of six months (1). For children to receive the maximum health benefits of breastfeeding, their mothers need information about these benefits and support from the start to maintain breastfeeding through infancy. New mothers are most likely to breastfeed exclusively when hospitals develop a breastfeeding policy and follow set protocols, such as: education for parents and health care providers, facilitating mother-baby contact, and limitations on items that discourage breastfeeding, e.g., formula and pacifiers (2, 3). Mothers sometimes discontinue breastfeeding due to lack of insurance coverage for lactation consultants or breast pumps.
Women are most likely to continue to breastfeed when policies on the job, in the family, and in communities support that effort (1). California state law gives mothers the right to breastfeed in public (4). With some exceptions, employers are required by California and federal law to provide breastfeeding employees with a private space and time to pump breast milk (5). In addition, family leave policies that allow women paid time off can help support efforts to breastfeed infants.
According to research and subject experts, policy options that could influence breastfeeding include:
- Enforcing state laws permitting breastfeeding in public places (4)
- Facilitating pumping breast milk in the workplace by enforcing employer compliance with laws (4, 5)
- Ensuring that hospitals adopt and implement breastfeeding policies, as recommended by the Academy of Breastfeeding Medicine and other leading international health organizations (2)
- Requiring health insurers to provide coverage for all aspects of breastfeeding support, such as lactation consultation and electric breast pumps (3)
- Supporting/encouraging paid maternal leave policies, as longer maternity leaves may increase breastfeeding duration (6)
- Including lactation and breastfeeding education in core competencies for health professionals working with infants, mothers, and families (7)
For more policy ideas and research about breastfeeding, see kidsdata.org’s Research & Links section, or visit the US Breastfeeding Committee, Womenshealth.gov, and Centers for Disease Control and Prevention.
Sources for this narrative:
1. Centers for Disease Control and Prevention. (2011). The Surgeon General’s call to action to support breastfeeding. Retrieved from: http://www.cdc.gov/breastfeeding/promotion/calltoaction.htm
2. The Baby Friendly Hospital Initiative. (n.d.). Retrieved from: http://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative/the-ten-steps
3. United States Breastfeeding Committee. (2008). Achieving exclusive breastfeeding in the United States. Retrieved from: http://www.usbreastfeeding.org/LinkClick.aspx?link=Publications%2fBarriers-EBF-2008-USBC.pdf&tabid=70&mid=388
4. California Civil Code sec. 43.3. Retrieved from: http://www.leginfo.ca.gov/cgi-bin/displaycode?section=civ&group=00001-01000&file=43-53
5. California Labor Code secs. 1030-1033. Retrieved from: http://www.leginfo.ca.gov/cgi-bin/displaycode?section=lab&group=01001-02000&file=1030-1033; Section 4207 of the Patient Protection and Affordable Care Act of 2010 (P.L. 111-148) [Federal Health Reform], amending Section 7 of the U.S. Fair Labor Standards Act.
6. Ogbuanu, C. et al. (2011). The effect of maternity leave length and time of return to work on breastfeeding. Pediatrics 127(6) e1414-e1427. Retrieved from: http://pediatrics.aappublications.org/content/early/2011/05/25/peds.2010-0459.abstract
7. United States Breastfeeding Committee. (2013). Core competencies in breastfeeding care and services for all health professionals. Retrieved from: http://www.usbreastfeeding.org/HealthCare/TrainingforHealthCareProfessionals/CoreCompetencies/tabid/225/Default.aspx
- Websites with Related Information
- Key Reports
- Breastfeeding-Related Maternity Practices at Hospitals and Birth Centers: United States, 2007, Centers for Disease Control and Prevention
- Does Breastfeeding Reduce the Risk of Pediatric Overweight?, Research to Practice Series No. 4, Centers for Disease Control and Prevention
- Evidence of the Long-Term Effects of Breastfeeding: Systematic Reviews and Meta-Analyses, World Health Organization
- Marketing Infant Formula Through Hospitals: The Impact of Commercial Hospital Discharge Packs on Breastfeeding, American Journal of Public Health
- Progress in Increasing Breastfeeding and Reducing Racial/Ethnic Differences, Morbidty and Mortality Weekly Report, Centers for Disease Control and Prevention
- The Effect of Maternity Leave Length and Time of Return to Work on Breastfeeding, Pediatrics
- The Surgeon General’s Call to Action to Support Breastfeeding, U.S. Department of Health and Human Services
- WIC Participation, Breastfeeding Practices, and Well-Child Care Among Unmarried Low-Income Mothers, American Journal of Public Health
- County/Regional Reports