MMWR Morb Mortal Wkly Rep. 2011 Aug 5;60(30):1020-5.
Childhood obesity is a national epidemic in the United States. Increasing the proportion of mothers who breastfeed is one important public health strategy for preventing childhood obesity. The World Health Organization and United Nations Children's Fund (UNICEF) Baby-Friendly Hospital Initiative specifies Ten Steps to Successful Breastfeeding that delineate evidence-based hospital practices to improve breastfeeding initiation, duration, and exclusivity.
In 2007 and 2009, CDC conducted a national survey of U.S. obstetric hospitals and birth centers. CDC analyzed these data to describe the prevalence of facilities using maternity care practices consistent with the Ten Steps to Successful Breastfeeding.
In 2009, staff members at most hospitals provide prenatal breastfeeding education (93%) and teach mothers breastfeeding techniques (89%) and feeding cues (82%). However, few hospitals have model breastfeeding policies (14%), limit breastfeeding supplement use (22%), or support mothers postdischarge (27%). From 2007 to 2009, the percentage of hospitals with recommended practices covering at least nine of 10 indicators increased only slightly, from 2.4% to 3.5%. Recommended maternity care practices vary by region and facility size.
Most U.S. hospitals have policies and practices that do not conform to international recommendations for best practices in maternity care and interfere with mothers' abilities to breastfeed.
Hospitals providing maternity care should adopt evidence-based practices to support breastfeeding. Public health agencies can set quality standards for maternity care and help hospitals achieve Baby-Friendly designation. Because nearly all births in the United States occur in hospitals, improvements in hospital policies and practices could increase rates of exclusive and continued breastfeeding nationwide, contributing to improved child health, including lower rates of obesity.
儿童肥胖是美国的一个全国性问题。增加母乳喂养母亲的比例是预防儿童肥胖的一项重要公共卫生策略。世界卫生组织和联合国儿童基金会（UNICEF）的爱婴医院倡议指定了成功母乳喂养的 10 个步骤，这些步骤描绘了基于证据的医院实践，以改善母乳喂养的开始、持续时间和排他性。
2007 年和 2009 年，疾病预防控制中心对美国产科医院和分娩中心进行了全国性调查。疾病预防控制中心分析了这些数据，以描述采用与成功母乳喂养的 10 个步骤一致的产妇保健实践的设施的流行率。
2009 年，大多数医院的工作人员提供产前母乳喂养教育（93%）并教授母亲母乳喂养技术（89%）和喂养提示（82%）。然而，很少有医院有模范母乳喂养政策（14%）、限制母乳喂养补充剂的使用（22%）或支持母亲产后（27%）。从 2007 年到 2009 年，至少有 9 项指标中推荐做法的医院比例仅略有增加，从 2.4%增加到 3.5%。推荐的产妇保健实践因地区和设施规模而异。
大多数美国医院的政策和做法不符合国际上关于产妇保健最佳实践的建议，这干扰了母亲母乳喂养的能力。
提供产妇保健的医院应采用基于证据的实践来支持母乳喂养。公共卫生机构可以为产妇保健制定质量标准，并帮助医院获得爱婴医院指定。由于美国几乎所有的分娩都发生在医院，因此改善医院政策和实践可以提高全国范围内纯母乳喂养和持续母乳喂养的比例，有助于改善儿童健康，包括降低肥胖率。
