Hospitals Still Don't Give Moms Enough Support For Breast-Feeding

Most hospitals around the country aren't doing a good job of helping new moms who want to breast-feed, researchers report Tuesday in the journal Morbidity and Mortality Weekly Report.

Several common practices at the institutions may actually prevent moms from sticking with breast-feeding for six months — the duration thought to be most healthful for babies.

Epidemiologists at the CDC surveyed more than 80 percent of the birthing centers across the country about the support they give new moms trying to breast-feed. About half of those surveyed said they implement five of the 10 practices recommended by the World Health Organization. By comparison, only a third of hospitals were hitting that mark in 2007.

"We've seen significant progress in recent years," Dr. Tom Frieden, the director of the Centers for Disease Control and Prevention, told reporters at a press conference. "But there's still more to be done. ... Hospitals really need to support women before, during and after their hospital stay."

And, too often, that's not happening. For example, about 75 percent of hospitals still give healthy babies some formula in the first days of life, even when moms say they want to breast-feed.

"Even a little bit of formula may undermine a strong start to breastfeeding," Frieden says.

Only about a third of hospitals offer women breast-feeding help after they leave the hospital — by referring women to support groups, for example, or checking in with them after they go home, or connecting them with lactation consultants.

Such support can be crucial for helping moms push through the early challenges of breast-feeding, says epidemiologist Cria Perrine, who led the study.

Many mothers say they quit breast-feeding because of pain, or because of concerns that they aren't producing enough milk, or because the baby is having trouble latching on correctly.

"These problems can be overcome with early professional support," Perrine says, especially in the first few days after moms go home from the hospital.

On the flip side, many birthing centers — about 90 percent — are teaching women how to breast-feed, Perrine and her colleagues found. And 65 percent are encouraging moms to breast-feed within the first hour after birth. "A mother needs every opportunity to express her milk in the beginning to establish her supply," Perrine says.

Pediatrician Valerie Flaherman at the University of California, San Francisco, tells Shots she agrees that getting moms to breast-feed right away in the hospital is important. But she thinks some of the 10 best practices recommended by the WHO could use some updating.

The list hasn't changed since it was first drafted more than 20 years ago, she says. "Practices like that should be periodically re-evaluated, perhaps every decade, looking at fresh evidence in the area."

For example, WHO recommends limiting an infant's use of a pacifier. But there's little scientific evidence to back up the claim that pacifiers inhibit breast-feeding, Flaherman says.

"Maybe there are other practices that have become more important — or we've discovered are more important — and we're not capturing them in the list," she says. "I mean, did we really get them perfectly right 20 years ago?"