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- Definition: Percentage of newborns fed breast milk during their hospitalization, by type of breastfeeding and race/ethnicity (e.g., in 2018, 66.3% of Hispanic/Latino infants born in a hospital to California women were breastfed exclusively during their hospitalization). Exclusive breastfeeding includes newborns who received breast milk only; any breastfeeding includes newborns who were breastfed exclusively and those who received both breast milk and formula.Number of newborns fed breast milk during their hospitalization, by type of breastfeeding and race/ethnicity (e.g., in 2018, 123,838 Hispanic/Latino infants born in a hospital to California women were breastfed exclusively during their hospitalization). Exclusive breastfeeding includes newborns who received breast milk only; any breastfeeding includes newborns who were breastfed exclusively and those who received both breast milk and formula.
- Data Source: California Dept. of Public Health, In-Hospital Breastfeeding Initiation Data (Oct. 2019).
- Footnote: Data are based on feedings from birth to the time of specimen collection by the Newborn Screening Program (usually 24 to 48 hours after birth). County-level data reflect the mother's county of residence. Race/ethnicity is based upon the mother's and father's race/ethnicity as reported on the birth certificate. Cases with unknown race/ethnicity are included in California totals. The notation S refers to (a) numbers that have been suppressed because there were fewer than 10 cases and (b) percentages that have been suppressed because there were fewer than 20 cases.
- Measures of Breastfeeding on Kidsdata.org
Kidsdata.org provides indicators of in-hospital breastfeeding initiation by mother's county of residence and newborn's race/ethnicity. Data are based on feedings from birth to the time of specimen collection by the California Department of Public Health's Newborn Screening Program (usually 24 to 48 hours after birth). Two types of breastfeeding are reported: (i) exclusive breastfeeding, which measures the number and percentage of newborns who receive breast milk only, and (ii) any breastfeeding, which measures the number and percentage of newborns who receive at least some breast milk (i.e., those who receive breast milk only and those who receive both breast milk and formula).
- 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 health, growth, and development (1). Infants who are breastfed receive protection from serious health conditions, including respiratory, ear, and gastrointestinal infections, allergies, diabetes, and obesity (1). Studies indicate that breastfeeding can reduce the incidence of Sudden Infant Death Syndrome (SIDS) when compared with formula feeding (1). Breastfeeding also offers health advantages to mothers, such as reducing the risk of breast and ovarian cancer, cardiovascular disease, and diabetes (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 breastfeed consistently due to occupational or other challenges (1, 5).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: https://pediatrics.aappublications.org/content/129/3/e827
2. Healthy People 2020. (n.d.). MICH-21: Increase the proportion of infants who are breastfed. U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/maternal-infant-and-child-health/objectives
3. California Department of Public Health, Maternal, Child and Adolescent Health Division. (n.d.). Profile: Breastfeeding Initiative. Retrieved from: https://www.cdph.ca.gov/Programs/CFH/DMCAH/CDPH%20Document%20Library/Communications/Profile-Breastfeeding.pdf
4. Sachs, H. C., & American Academy of Pediatrics Committee on Drugs. (2013). The transfer of drugs and therapeutics into human breast milk: An update on selected topics. Pediatrics, 132(3), e796-e809. Retrieved from: https://pediatrics.aappublications.org/content/132/3/e796
5. Center for Law and Social Policy, & BreastfeedLA. (2016). Public policies to support breastfeeding: Paid family leave and workplace lactation accommodations. Retrieved from: https://www.clasp.org/resources-and-publications/public-policies-to-support-breastfeeding-paid-family-leave-and-workplace-lactation-accommodations
- How Children Are Faring
Among California newborns delivered in a hospital in 2018, 70% were breastfed exclusively during their hospitalization, up from 57% in 2010. At the county level, percentages ranged from 37% (Shasta County) to 91% (Nevada County) in 2018, among regions with data. Since 2010, rates of exclusive breastfeeding have been consistently higher for white newborns (81% in 2018) than for newborns in other racial/ethnic groups statewide.
- Policy Implications
Recognizing that breastfeeding has significant health benefits for children and mothers, all major health organizations recommend that infants be breastfed exclusively 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 87% of California infants start out breastfeeding, only 26% are breastfed exclusively 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 and practices that keep mothers and infants together, facilitate breastfeeding within one hour after birth, and limit items that discourage breastfeeding (e.g., formula and pacifiers) (2). After leaving the hospital, 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 systems, child care providers, families, and communities support that effort (2).
Policy options that could increase breastfeeding include:
For more information about breastfeeding, see kidsdata.org’s Research & Links section, or visit the U.S. Breastfeeding Committee and the Centers for Disease Control and Prevention.
- 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)
- 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 (6)
Sources for this narrative:
1. Centers for Disease Control and Prevention. (2018). Breastfeeding report card – United States, 2018. Retrieved from: https://www.cdc.gov/breastfeeding/data/reportcard.htm
2. California WIC Association, & UC Davis Human Lactation Center. (2014). Bringing breastfeeding home: Building communities of care. Retrieved from: https://www.calwic.org/storage/documents/FactSheets2014/full_report_2014_FINALxx.pdf
3. Center for Law and Social Policy, & BreastfeedLA. (2016). Public policies to support breastfeeding: Paid family leave and workplace lactation accommodations. Retrieved from: https://www.clasp.org/resources-and-publications/public-policies-to-support-breastfeeding-paid-family-leave-and-workplace-lactation-accommodations
4. Fair Labor Standards Act of 1938, 29 U.S.C. § 207(r) (1938 & 2010). Retrieved from: https://www.gpo.gov/fdsys/pkg/USCODE-2013-title29/html/USCODE-2013-title29-chap8-sec207.htm
5. Cal. Lab. Code §§ 1030-1033 (2001). Retrieved from: https://leginfo.legislature.ca.gov/faces/codes_displayText.xhtml?lawCode=LAB&division=2.&title=&part=3.&chapter=3.8.
6. Cal. Civ. Code § 43.3 (1997). Retrieved from: https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=CIV§ionNum=43.3.
- Websites with Related Information
- Academy of Breastfeeding Medicine
- American Academy of Pediatrics: Breastfeeding
- California Breastfeeding Coalition
- California Dept. of Public Health: Breastfeeding
- California WIC Association: Breastfeeding Advocacy
- Centers for Disease Control and Prevention: Breastfeeding
- United States Breastfeeding Committee
- Womenshealth.gov: Breastfeeding. U.S. Dept. of Health and Human Services, Office on Women’s Health.
- World Health Organization: Breastfeeding
- Key Reports and Research
- Achieving Breastfeeding Equity in California California: Are Hospitals Doing Enough to Support At-Risk Families? (2020). California WIC Association & UC Davis Human Lactation Center.
- Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. (2018). Pediatrics. Schwarzenberg, S. J., et al.
- Breastfeeding Report Card – United States, 2020. Centers for Disease Control and Prevention.
- Breastfeeding Trends by Race/Ethnicity Among U.S. Children Born from 2009 to 2015. (2019). JAMA Pediatrics. Li, R., et al.
- 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.
- Feeding Infants and Children from Birth to 24 Months: Summarizing Existing Guidance. (2020). National Academies of Sciences, Engineering, and Medicine.
- Improvements in Maternity Care Policies and Practices that Support Breastfeeding – United States, 2007-2013. Morbidity and Mortality Weekly Report. Perrine, C. G., et al.
- Lactation Support for Low-Wage Workers. (2020). California WIC Association, California Breastfeeding Coalition, & California Dept. of Public Health.
- 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.
- Nine Steps to Breastfeeding Friendly: Guidelines for Community Health Centers and Outpatient Care Settings. (2015). California Dept. of Public Health.
- Percent of Infants Breastfed: Evidence Brief. (2014). National Center for Education in Maternal and Child Health. DeFrancis, B.
- Public Policies to Support Breastfeeding: Paid Family Leave and Workplace Lactation Accommodations. (2016). Center for Law and Social Policy & BreastfeedLA.
- Racial and Ethnic Disparities in Breastfeeding. (2015). Breastfeeding Medicine. Jones, K. M., 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.
- County/Regional Reports
- 2020-21 California County Scorecard of Children's Well-Being. Children Now.
- Annual Report on the Conditions of Children in Orange County. Orange County Children's Partnership.
- Community Health Improvement Plan for Los Angeles County. Los Angeles County Dept. of Public Health.
- Key Indicators of Health by Service Planning Area. (2017). Los Angeles County Dept. of Public Health.
- Live Well San Diego Report Card on Children, Families, and Community. San Diego Children’s Initiative.
- Pathway to Progress: Indicators of Young Child Well-Being in Los Angeles County. First 5 LA.
- San Mateo County All Together Better. San Mateo County Health.
- More Data Sources For Breastfeeding
- Breastfeeding Rates: National Immunization Survey. Centers for Disease Control and Prevention.
- California In-Hospital Breastfeeding Initiation Data. California Dept. of Public Health.
- California WIC Association: Hospital Breastfeeding Rates and Reports
- Health, United States – Data Finder. National Center for Health Statistics.
- Maternal and Infant Health Assessment (MIHA). California Dept. of Public Health & University of California San Francisco.
- National Survey of Children's Health. Child and Adolescent Health Measurement Initiative.
- PeriStats. March of Dimes Perinatal Data Center.
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