Maternity Practices in Infant Nutrition and Care (mpinc) Survey: A Catalyst for Change

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1 Maternity Practices in Infant Nutrition and Care (mpinc) Survey: A Catalyst for Change Jennifer M. Nelson, MD, MPH Medical Epidemiologist Centers for Disease Control and Prevention AHA Webinar October 20, 2016 National Center for Chronic Disease Prevention and Health Promotion Division of Nutrition, Physical Activity, and Obesity Photo credit:

2 Breastfeeding Optimal source of infant nutrition Benefits to infant Decreased incidence of illness and infection Benefits to mother Decreased incidence of breast and ovarian cancers Decreased cardiovascular disease American Academy of Pediatrics (AAP): Exclusive breastfeeding for 6 months Continued breastfeeding for at least 1 year with complementary food introduction American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics 2005; 115: Available: Photo credit:

3 Breastfeeding: Economic Benefits Decreased Annual direct and indirect health care costs ($3.6 billion/year) Benefits to employers Significant Return on Investment (ROI) Breastfeeding employees miss less work Breastfeeding lower health care costs Higher productivity and loyalty Positive public relations Photo credit:

4 Percentage of Infants Breastfeeding 100 Any Breastfeeding 80 Exclusive Breastfeeding % Age (months) Exclusive breastfeeding is defined as only breast milk and needed medications or vitamins CDC s National Immunization Survey, among children born in 2013

5 CDC Guide to Breastfeeding Interventions Surgeon General s Call to Action to Support Breastfeeding HHS Blueprint for Action on Breastfeeding CDC advised to monitor maternity practices 1 st mpinc Survey 2 nd mpinc Survey 3 rd mpinc Survey 4 th mpinc Survey 5 th mpinc Survey mpinc planning begins Healthy People 2020 Baby-Friendly measure introduced Best Fed Beginnings ( ) EMPower Breastfeeding ( )

6 Maternity Practices in Infant Nutrition and Care (mpinc) Survey Photo credit: www. choicesinchildbirth.org

7 Hospital Support of Breastfeeding Experiences during maternity stay influence infant feeding Barriers: Low priority Insufficient knowledge and clinical competence Fragmented care Inappropriate routines Photo credit:

8 % who breastfed < 6 weeks Cessation of breastfeeding before 6 weeks and evidence-based hospital practices Steps measured: Early initiation No supplementation Rooming-in On-demand feedings No pacifiers Information provided Number of Ten Steps to Successful Breastfeeding experienced DiGirolamo et al. Pediatrics, 2008

9 mpinc Survey Launched in 2007 Administered every 2 years Census of all hospitals and birth centers Breastfeeding-related maternity care practices and policies Key informant Response rate >80% Photo credit: Image credit: jcgoforth on flickr

10 mpinc Survey Labor and Delivery Care Postpartum Care Feeding of breastfed infants Breastfeeding assistance Contact between mother and infant Facility Discharge Care Staff Training and Education Structural and Organizational Aspects of Care

11 mpinc Data Photo credit:

12 Facility-Specific Benchmark Report

13 Average mpinc Total Score, Score Year

14 Facility-Specific Benchmark Report: Sub-score

15 Average mpinc Sub-Scores, Maternity Care Practice Domain Labor & Delivery Feeding of Breastfed Infant Breastfeeding Assistance Mother Infant Contact Discharge Care Staff Training Structural & Organizational Aspects

16 State-Specific Results Report

17 mpinc Web Data Tables

18 2015 mpinc data availability Hospital-specific Benchmark Reports Hard copies mailed to: o Hospital Administrator/CEO o Director of Obstetrics o Director of Pediatrics o Director of Quality Improvement o Mother-Baby Nurse Manager o Survey recipient Questions: State-specific Reports ed to state-level organizations and others Available: National Web Tables Available:

19 Hospital Provision of Non-Breast Milk Supplements, mpinc Nelson JM, et al. Provision of Non-breast Milk Supplements to Healthy Breastfed Newborns in U.S. Hospitals, 2009 to Matern Child Health J 2016; DOI /s

20 Proportion of Hospitals Providing Non-Breast Milk Supplements to Healthy, Full-Term Breastfed Infants, mpinc (n=2297) (n=2448) (n=2340) % % % Proportion of hospitals 0% % to 24% % >50%

21

22 Vital Signs: Hospital Support for Breastfeeding, 2011

23 Vital Signs: Hospital Actions Affect Breastfeeding, 2015

24

25 Best Fed Beginnings Cooperative agreement to the National Institute for Children s Health Quality (NICHQ) Partnership with Baby-Friendly USA Goals: Improve maternity practices that support breastfeeding Increase the number of U.S. hospitals designated as Baby- Friendly 89 hospitals 75 (84%) achieved Baby-Friendly designation

26 EMPower Breastfeeding: Enhancing Maternity Practices for Breastfeeding Contract to Abt Associates Partnership with Carolina Global Breastfeeding Institute, the Center for Public Health Quality, and Baby-Friendly USA Goals: Increase number of U.S. hospitals designated as Baby-Friendly Identify best practices for achieving Baby-Friendly designation 93 hospitals 3 designated as Baby-Friendly

27 Percent of annual U.S. live births Percent of U.S. births occurring in Baby-Friendly facilities facilities 18.8% October facilities November facilities August 2013 Healthy People 2020 Target = 8.1% facilities August facilities August % in 2011

28 Conclusions Breast milk is optimal nutrition for infants Maternity care facilities play critical role mpinc data important for monitoring changes in breastfeeding-related maternity practices Supportive practices are improving in the U.S. Continued need to emphasize importance of evidence-based maternity care practices

29

30 For more information please contact: 1600 Clifton Road NE, Atlanta, GA Telephone: CDC-INFO ( )/TTY: Visit: Contact CDC at: CDC-INFO or The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion Division Nutrition, Physical Activity, and Obesity Photo credit:

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