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- Definition: Percentage 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 Dept. of Public Health, Center for Family Health, Newborn Screening Program Data, Breastfeeding Data (May 2015).
- Footnote: Data are based on the mother's county of residence as recorded on the birth certificate. The California Dept. of Public Health provides margins of error because the forms used to collect these data are not always complete. In 2013, 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 +/-0.2. 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.
- Measures of Breastfeeding on Kidsdata.org
Kidsdata.org provides data on the number and percentage of newborns who breastfeed during their hospitalization after birth. The data include Exclusive Breastfeeding (those who breastfeed only) and Any Breastfeeding (those who breastfeed exclusively and those who breastfeed and receive formula). This indicator also is available by race/ethnicity, as a number and a percentage.
- 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). And not all women can consistently breastfeed due to occupational or other challenges.
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, Section on Breastfeeding. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841. Retrieved from: http://pediatrics.aappublications.org/content/129/3/e827
2. California Department of Public Health: Maternal, Child and Adolescent Health Program. (2013). Breastfeeding fact sheet. Retrieved from: http://www.cdph.ca.gov/healthinfo/healthyliving/childfamily/Pages/BreastfeedingProgramFactSheet.aspx
3. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2012). Healthy People 2020: Maternal, infant, and child health, MICH-21. Retrieved from: http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives
- How Children Are Faring
In 2013, about 65% of California infants were exclusively breastfed in the hospital after birth, up from 57% in 2010, At the county level, figures ranged from 32% to 92% in 2013. Statewide, White infants continue to have the highest percentages of exclusive breastfeeding (79% in 2013) compared to infants of other racial/ethnic groups.
- Policy Implications
While data have shown that 74% of U.S. mothers start out breastfeeding, only 34% of babies are exclusively breastfed at the end of three 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 (2). 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 (3, 4). 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, 2). California state law gives mothers the right to breastfeed in public (5). 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 (6). 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:
For more policy ideas and research about breastfeeding, see kidsdata.org’s Research & Links section, or visit the U.S. Breastfeeding Committee, Womenshealth.gov, and Centers for Disease Control and Prevention.
- Enforcing state laws permitting breastfeeding in public places (5)
- Facilitating pumping breast milk in the workplace by enforcing employer compliance with laws (5, 6)
- Ensuring that hospitals adopt and implement breastfeeding policies, as recommended by the Academy of Breastfeeding Medicine and other leading international health organizations (3)
- Requiring health insurers to provide coverage for all aspects of breastfeeding support, such as lactation consultation and electric breast pumps (4)
- Supporting/encouraging paid maternal leave policies, as longer maternity leaves may increase breastfeeding duration (7)
- Including lactation and breastfeeding education in core competencies for health professionals working with infants, mothers, and families (8)
Sources for this narrative:
1. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2012). Healthy People 2020: Maternal, infant, and child health, MICH-21. Retrieved from: http://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives
2. U.S. Department of Health and Human Services, Office of the Surgeon General. (2011). The Surgeon General’s call to action to support breastfeeding. Retrieved from: http://www.surgeongeneral.gov/library/calls/breastfeeding/
3. Baby-Friendly USA. (n.d.). The ten steps to successful breastfeeding. Retrieved from: http://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative/the-ten-steps
4. Labbok, M., & Taylor, E. (2008). Achieving exclusive breastfeeding in the United States: Findings and recommendations. United States Breastfeeding Committee. Retrieved from: http://www.usbreastfeeding.org/p/cm/ld/fid=197
5. Cal. Civ. Code § 43.3 (1997). Retrieved from: http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=43.3.
6. Cal. Lab. Code §§ 1030-1033 (2001). Retrieved from: http://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=LAB&division=2.&title=&part=3.&chapter=3.8.; Fair Labor Standards Act of 1938, 29 U.S.C. § 207(r) (1938 & 2010). Retrieved from: http://www.gpo.gov/fdsys/pkg/USCODE-2013-title29/html/USCODE-2013-title29-chap8-sec207.htm
7. 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/127/6/e1414
8. United States Breastfeeding Committee. (2010). Core competencies in breastfeeding care and services for all health professionals (Rev. ed.). Retrieved from: http://www.usbreastfeeding.org/p/cm/ld/fid=170
- Websites with Related Information
- Academy of Breastfeeding Medicine
- American Academy of Pediatrics: Breastfeeding Initiatives
- California Breastfeeding Coalition
- California Dept. of Public Health: Breastfeeding & Healthy Living
- California WIC Association: Breastfeeding Advocacy Initiatives
- Centers for Disease Control and Prevention: Breastfeeding
- National Center for Education in Maternal and Child Health: Breastfeeding Professional Resource Brief, Georgetown University
- United States Breastfeeding Committee
- Womenshealth.gov: Breastfeeding, U.S. Dept. of Health and Human Services, Office on Women’s Health
- Key Reports
- 9 Steps to Breastfeeding Friendly: Guidelines for Community Health Centers and Outpatient Care Settings, 2015, California Dept. of Public Health
- Breastfeeding Among Minority Women: Moving from Risk Factors to Interventions, 2012, Advances in Nutrition, Chapman, D. J., & Pérez-Escamilla, R.
- Breastfeeding Report Card: Progressing toward National Breastfeeding Goals, 2016, Centers for Disease Control and Prevention
- Breastfeeding: An Overview of Oral and General Health Benefits, 2013, Journal of the American Dental Association, Salone, L. R., et al.
- Bringing Breastfeeding Home: Building Communities of Care, 2014, California WIC Association & UC Davis Human Lactation Center
- Long-Term Effects of Breastfeeding: A Systematic Review, 2013, World Health Organization, Horta, B. L., & Victora, C. G.
- Maternity Leave Duration and Full-Time/Part-Time Work Status Are Associated with U.S. Mothers’ Ability to Meet Breastfeeding Intentions, 2014, Journal of Human Lactation, Mirkovic, K. R., et al.
- Public Policies to Support Breastfeeding: Paid Family Leave and Workplace Lactation Accommodations, 2016, CLASP & Breastfeed LA
- Racial and Ethnic Disparities in Breastfeeding, 2015, Breastfeeding Medicine, Jones, K. M., et al.
- Racial Disparities in Access to Maternity Care Practices that Support Breastfeeding – United States, 2011, 2014, Morbidity and Mortality Weekly Report, Lind, J. N., et al.
- The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies, 2013, Centers for Disease Control and Prevention
- The Impact in the United States of the Baby-Friendly Hospital Initiative on Early Infant Health and Breastfeeding Outcomes, 2016, Breastfeeding Medicine, Munn, A. C., et al.
- The Surgeon General’s Call to Action to Support Breastfeeding, 2011, U.S. Dept. of Health and Human Services, Office of the Surgeon General
- Vital Signs: Improvements in Maternity Care Policies and Practices that Support Breastfeeding – United States, 2007-2013, 2015, Morbidity and Mortality Weekly Report, Perrine, C. G., et al.
- County/Regional Reports
- Breastfeed LA
- California WIC Association: Hospital Breastfeeding Rates & Reports
- Community Health Assessment 2015, Los Angeles County Dept. of Public Health
- Fresno Community Scorecard
- San Diego County Report Card on Children and Families, 2015, The Children's Initiative & Live Well San Diego
- The 21st Annual Report on the Conditions of Children in Orange County, 2015, Orange County Children's Partnership
- More Data Sources For Breastfeeding
- 2016-17 California County Scorecard of Children's Well-Being, Children Now
- California WIC Association: Hospital Breastfeeding Rates & Reports
- Child Trends Databank: Breastfeeding
- National Immunization Survey (NIS) Breastfeeding Data & Statistics, Centers for Disease Control and Prevention