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Session: Feeding the Future: Infant Feeding Practices (Oral 13)

(OR13-06-24) Longitudinal Association of Maternity Care Practices With Exclusive Breastfeeding in U.S. Hospitals, 2018–2022

Sunday, June 30, 2024
11:00 AM – 11:12 AM CT
Location:  W375A
Objectives: To examine the longitudinal association of hospital maternity care practices and policies with in-hospital exclusive breastfeeding (EBF) rates from 2018 to 2022.

Methods: Hospitals completing ≥2 surveys during 2018, 2020, and 2022 cycles of CDC’s national Maternity Practices in Infant Nutrition and Care (mPINC) survey were included to form a nested longitudinal cohort (n=2,115). Hospitals were given a modified mPINC score (0 to 100 points) based on self-reported adherence to maternity care practices and polices supportive of breastfeeding including skin-to-skin contact, monitoring following birth, rooming-in, feeding counseling and education, and institutional policies. Hospitals reported their EBF rates at discharge. A path analysis (multi-mediation model) quantified the total (direct + indirect) effects of modified mPINC scores on in-hospital EBF rates in subsequent survey cycles controlling for the number of annual births.

Results: Among hospitals with the highest modified mPINC scores of 100 points, the mean in-hospital EBF rates were 62.0% in 2018 (n=129), 62.2% in 2020 (n=132), and 61.7% in 2022 (n=138); whereas hospitals with the lowest scores of < 60 points had EBF rates of 40.6% (n=247), 41.9% (n=173), and 37.8% (n=127) respectively. In an adjusted path analysis with good fit (Root Mean Square Error of Approximation=0.035; Standardized Root Mean Square Residual=0.018), each 10-point higher modified mPINC score in 2018 was associated with a total 4.4 (95% CI: 3.9, 5.0) percentage point higher EBF rate in 2022 through increasing the likelihood of having higher in-hospital EBF rates in 2018 and 2020 and having higher modified mPINC scores in 2020 and 2022.

Conclusions: Improving and maintaining maternity care practices and polices supportive of breastfeeding is associated with higher in-hospital exclusive breastfeeding over time.

Funding Sources: Centers for Disease Control and Prevention