Breastfeeding Report Card—United States, 2012
Background
Improving the health of mothers and their children is a primary goal of the Centers for Disease Control and Prevention (CDC). Protecting, promoting, and supporting breastfeeding, with its many known benefits for infants, children, and mothers, is a key strategy toward this goal.There are many ways that states support mothers and babies to breastfeed, and everyone plays a role. The CDC Breastfeeding Report Card brings together state-by-state information to help tell the story of breastfeeding practices in states. It compiles many types of data so states can monitor progress, celebrate state successes, and identify opportunities to work with health professionals, employers, business owners, community partners and family members to protect, promote, and support breastfeeding.
Breastfeeding rates on the rise
Breastfeeding rates continue to rise, with increases of about 2 percentage points in breastfeeding initiation, and breastfeeding at 6 and 12 months. Breastfeeding initiation increased from 74.6% in 2008 to 76.9% in 2009 births. This improvement in initiation represents the largest annual increase over the previous decade. Breastfeeding at 6 months increased from 44.3% to 47.2%; breastfeeding at 12 months increased from 23.8% to 25.5%.Progress in improving hospital practices
CDC’s Maternity Practices in Infant Nutrition and Care (mPINC) survey assesses and scores how well maternity care practices at hospitals and birth centers support breastfeeding, on a scale of 0–100, with a higher score indicating better practices. From 2009 to 2011 the national average mPINC score increased from 65 to 70, and scores increased by 5 or more points in 26 states and DC. The last few years also have seen acceleration in the percent of babies that are born in hospitals designated as Baby-Friendly, an international recognition of best practices in maternity care. In 2008, less than 2% of births occurred in Baby Friendly facilities. In the last 4 years that number has more than tripled to 6%. While both of these indicators show national improvement in hospital maternity care practices, they also suggest that many mothers are not receiving the quality of care that will give them the best possible start to meeting their breastfeeding intentions.Breastfeeding Report Card Indicators- 2012
Each indicator is measured in every state, allowing easy state-by-state comparisons.Outcome Indicators
Five indicators profile the extent to which infants in a state are breastfed. Many of these are the breastfeeding goals outlined in Healthy People 2020, a description of the nation's health priorities.For more, see Breastfeeding Report Card, United States: Outcome Indicators.
Process Indicators
Elements of breastfeeding-friendly communities are measured using indicators, measuring support from birth facilities, health professionals and child care settings.For more, see Breastfeeding Report Card, United States: Process Indicators.
Percent of births at Baby-Friendly facilities in 2012, by state |
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Data Source: CDC National Survey of Maternity Practices in Infant Nutrition and Care (mPINC) |
Data Source: Baby-Friendly facilities : www.babyfriendlyusa.org & Live Births: CDC NCHS Live Births by State. |
Breastfeeding rates for infants born in 2009 from the U.S. National Immunization Surveys, 2010-11
- Ever Breastfed
- Breastfeeding at 6 months
- Breastfeeding at 12 months
- Exclusive breastfeeding at 3 months
- Exclusive breastfeeding at 6 months
Birth Facility Support
- State Maternity Practices in Infant Nutrition and Care (mPINC) score
- Percent of live births occurring at facilities designated as Baby-Friendly
- Percentage of breastfed infants receiving formula before 2 days of age
Two initiatives, one national and one global, provide informative measures of birth facility support. The mPINC Survey initiated by CDC, measures breastfeeding-related maternity care practices at intrapartum care facilities across the US and compares the extent to which these practices vary by state. Thus, the state mPINC score represents the extent to which each state’s birth facilities provide maternity care that supports breastfeeding.
The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for lactation based on the WHO/UNICEF Ten Steps to Successful Breastfeeding for Hospitals.
Mother-to-Mother Support
- Number of La Leche League Leaders per 1,000 live births
Professional Support
- Number of International Board Certified Lactation Consultants (IBCLCs) per 1,000 live births
Support in Child Care Settings
- States child care regulation support onsite breastfeeding
Data Sources
- Breastfeeding outcome indicators – Ever Breastfed, Breastfeeding at 6 months, Breastfeeding at 12 months, Exclusive breastfeeding at 3 months, Exclusive breastfeeding at 6 months
- Source: CDC National Immunization Surveys 2010 and 2011, Provisional Data, 2009 births. http://www.cdc.gov/breastfeeding/data/NIS_data/index.htm
- Breastfeeding process indicators
- Average mPINC Score
2011 CDC Maternity Practices in Infant Nutrition and Care (mPINC) Survey.
http://www.cdc.gov/breastfeeding/data/mpinc/index.htm - Percent of live births at facilities designated as Baby Friendly (BFHI)
Sources: Baby Friendly USA. Baby-Friendly Hospitals and Birth Centers as of June 2012. Available at http://www.babyfriendlyusa.org/eng/03.html - Number of La Leche League Leaders per 1,000 live births.
Source: Personal Communication with La Leche League USA, June 2012. Group listing available at http://www.lllusa.org/groups.php - Number of IBCLCs per 1,000 live births
Source: International Board of Lactation Consultant Examiners. IBCLC Facts and Figures as of April 24, 2012. Source: http://americas.iblce.org/facts-and-figures Accessed 6/20/2012. - States child care regulation fully supports onsite breastfeeding
Source: National Resource Center for Health and Safety in Child Care and Early Education, University of Colorado Denver. 2011. National Resource Center for Health and Safety in Child Care and Early Education: Achieving a State of Healthy Weight: A National Assessment of Obesity Prevention Terminology in Child Care Regulations 2011. Aurora, CO. - Births by state
Source: Total live birth information: Martin, J., et al., Births: Preliminary data for 2010. National vital statistics reports, 2011. 60(1): p. 1-70. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_02.pdf . Accessed 6/20/2012.
- Average mPINC Score
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