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 infant's race/ethnicity, as a number and a percentage.

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, and obesity (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, 2). In fact, California has a statewide goal to make breastfeeding the normal method of infant feeding for at least the first year of life (3).

Not all women should breastfeed, however. For example, breastfeeding is not recommended for women who test positive for HIV, use certain drugs, or have active, untreated tuberculosis (1, 4). And not all women can consistently breastfeed due to occupational or other challenges (1, 5).

In 2014, about 67% of California infants were exclusively breastfed in the hospital after birth, up from 57% in 2010. At the county level, figures ranged from 31% to 90% in 2014. Statewide, white infants continue to have the highest percentages of exclusive breastfeeding in the hospital (80% in 2014) compared to infants of other racial/ethnic groups.

Recognizing that breastfeeding has significant health benefits for children and mothers, all major health organizations recommend that infants be exclusively breastfed for the first six months, followed by continued breastfeeding with complementary foods until at least 12 months (1). While breastfeeding rates generally have been on the rise, and 90% of California infants start out breastfeeding, only 25% of babies are exclusively breastfed at the end of six months (1).

To increase breastfeeding rates, mothers need information about its benefits and support from the start to maintain breastfeeding through infancy (2). New mothers are more likely to breastfeed exclusively when hospitals develop breastfeeding policies, such as Baby-Friendly hospital practices, including routinely educating mothers and health care staff, facilitating breastfeeding within one hour after birth, keeping mothers and infants together, and limiting items that discourage breastfeeding (e.g., formula and pacifiers) (2). Mothers sometimes discontinue breastfeeding due to lack of insurance coverage for lactation consultants or breast pumps, or due to other barriers such as unsupportive workplaces (2). Continued breastfeeding is more likely when employers, health care providers and insurers, child care providers, families, and communities support that effort (2).

Policy options that could increase breastfeeding include:

• Continuing efforts to ensure that all California hospitals adopt and effectively implement infant-feeding policies aligned with the Baby-Friendly Hospital Initiative, as required by law; hospitals also need sufficient qualified professionals to support all new mothers with breastfeeding (2)
• Promoting collaboration among hospitals, health care providers, public health agencies, insurers, and other community partners to guarantee that new mothers continue to receive culturally competent, skilled support for lactation after they leave the hospital (2)
• Requiring health insurers to cover best practices for breastfeeding support, including in-person access to International Board Certified Lactation Consultants and quality breast pumps (2)
• Supporting and expanding paid family leave policies, as longer maternity leaves may increase breastfeeding duration (3)
• Facilitating pumping breast milk in the workplace by educating employers and improving enforcement of existing laws, which require employers (with some exceptions) to provide breastfeeding employees with a private space and time to pump breast milk (2, 4, 5)
• Promoting breastfeeding education for child care providers, so they can help support exclusive breastfeeding for children in their care, when needed (2)
• Enforcing state law permitting breastfeeding in public places (4)