Initiative increases breastfeeding rates in Mississippi hospitals
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A multiyear initiative in Mississippi increased breastfeeding and reduced racial inequities, according to a study led by Boston Medical Center researchers.
The Communities and Hospitals Advancing Maternity Practices (CHAMPS) program also increased rates of skin-to-skin contact immediately after birth and rooming-in practices, which keep mother and baby together in the same hospital room.
“Two of the biggest factors that play into breastfeeding outcomes are race or racism and where you live, which the CHAMPS program addresses at the hospital level, providing the information and support necessary to help all new mothers be successful with breastfeeding,” author Laura Burnham, MPH, associate director of the Center for Health Equity, Education & Research (CHEER) at Boston Medical Center, said in a press release.
Children who have been breastfed perform better on intelligence tests and are less likely to be overweight or obese or develop diabetes later in life, the researchers said, adding that women who breastfeed also see a reduced risk of breast and ovarian cancers.
In 2014, Mississippi had the lowest breastfeeding rates in the nation at 57.5%, which was nearly 10 points less than any other state, the researchers said. African American breastfeeding rates in Mississippi also were the lowest in the United States due to institutional racism, poverty and traumatic experiences, the researchers added. Mississippi had some of the highest rates of heart disease, obesity and diabetes as well.
According to the release, CHAMPS enrolled 39 of Mississippi’s 43 birthing hospitals between January 2015 and December 2019. Participants received coaching and technical assistance to implement the WHO and United Nations Children’s Fund Baby-Friendly Hospital Initiative, which helps new mothers initiate and continue breastfeeding. Hospitals that achieve specific goals are designated as “baby friendly.”
Local breastfeeding experts and lactation consultants, local and statewide organizations and other stakeholders also provided support. Hospitals reported data on breastfeeding initiation and exclusivity, skin-to-skin care and rooming-in practices to CHAMPS, which reported the data back to the hospitals to analyze and track changes over time.
Results of the program, published in Pediatrics, showed that overall breastfeeding initiation rates rose from 56% to 66% (P < .005). Rates increased by 21 points for Black mother-baby dyads and by 4 points for white mother-baby dyads, which decreased the disparity between the two groups by 17 percentage points, or an average 0.176 percentage points per month (95% CI, –0.06 to –0.292). Exclusive breastfeeding rates increased from 26% to 37% (P < .005), with higher monthly increases among Black mother-baby dyads.
Skin-to-skin rates for vaginal and cesarean births also increased, from 31% to 91% and 20% to 86%, respectively, among both Black and white mother-baby dyads (P < .01 for both). Black and white mother-baby dyads additionally saw increases in rooming-in rates from 19% to 86% (P < .01).
Also, the number of hospitals distributing free formula sample packs to patients decreased from 79% to 11%, with a significant reduction in the number of hospitals that accepted free formula from manufacturers.
During the program, CHAMPS conducted 100 training sessions throughout the state, training 1,837 hospital staff. Plus, the number of Baby Friendly hospitals rose from zero in 2014 to 22 today.
“Expanding access to breastfeeding support in Mississippi is a critical component of addressing health equity for families both in the short and long term,” author Anne Merewood, PhD, MPH, director of CHEER at Boston Medical Center, said in the press release. “We know that there are tremendous health benefits related to breastfeeding for both mother and child, and we need to identify sustainable solutions to maintain these efforts in the future.”