DefinitionProportion of breastfeeding infants who receive formula supplementation before 2 days of age
NumeratorNumber of breastfeeding infants who receive formula supplementation before 2 days of age
DenominatorNumber of breastfeeding infants who are 2 days of age
Why Is This Important?Nearly all births in the US occur in hospitals, but hospital practices and policies in maternity settings can undermine maternal and infant health by creating barriers to supporting a mother's decision to breastfeed. National data indicate that barriers to breastfeeding are widespread during labor, delivery, and postpartum care, as well as in hospital discharge planning.[http://www.cdc.gov/breastfeeding/promotion/healthcare.htm
Healthy People Objective: Reduce the proportion of breastfed newborns who receive formula supplementation within the first 2 days of lifeU.S. Target: 14.2 percent
State Target: 10.0 percent
Other Objectives'''Healthy New Jersey 2020 Objective MCH-8''': Reduce the proportion of breastfeeding infants who receive formula supplementation before two days of age to 10%.
What Is Being Done?The New Jersey Department of Health's Division of Family Health Services calls on all medical providers to implement evidence-based practices to promote and support breastfeeding. The Division prepares an annual comparative report on the exclusive breastfeeding rates at the time of discharge for all delivery hospitals and shows a standardized score for each hospital based on the demographic and medical characteristics of the patient population. The report allows hospitals to compare their rates to other hospitals in their region and to other hospitals with similar designations and demonstrates the need for quality reporting. It provides pregnant women with information about which hospitals have better breastfeeding outcomes.
In December, 2013, the Department adopted amended Hospital Licensing Standards that require hospitals to develop and implement written policies and procedures for identifying and supporting the needs of a breastfeeding mother and/or child at the point of entry into the facility, including the emergency department; written policies and procedures for the obstetrics unit that include competencies of obstetrics staff regarding infant feeding, distribution of printed materials about infant feeding, cultural competence of obstetrics staff, professional resources for use by obstetrics staff, formula supplementation, rooming-in, pacifier use, breastfeeding assistance, and labeling and storage of human milk and infant formula; and discharge planning.
Hospitals are required to establish an interdisciplinary breastfeeding team and use evidence-based resources including "Implementing the Joint Commission Perinatal Care Core Measure on Exclusive Breastmilk Feeding" regarding perinatal patient care that address allowing newborns to remain with the mother or primary caregiver during the first hour following delivery, performing newborn assessments while the newborn remains with the mother (unless contraindicated) and offer support and assistance to mothers who wish to breastfeed during the first hour after their infants' births. Other requirements include readily available breast pumps, and provision of a breast pump to a mother within four hours of her infant's separation from her, e.g., to the NICU, or ineffective breastfeeding; education and training for staff who provide breastfeeding care and staff ability to demonstrate proficiency in core competencies prior to providing related patient care; and establishment of an interdisciplinary breastfeeding team that represents various professional healthcare disciplines and lay groups.
These Standards took effect on January 21, 2014, with the goal of increasing exclusive breastfeeding rates, improving health outcomes of mothers and infants, reducing childhood obesity rates, and containing healthcare costs.
The WIC Program, which serves about half of the infants born in New Jersey, provides breastfeeding education to pregnant women and support services to breastfeeding women who participate in the Program.
The Division of Family Health Services is working with the New Jersey Hospital Association and other partners to support hospitals to attain the Baby-Friendly Hospital designation.