Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
U.S. Public Health Service Commissioned Corps, Washington, DC.
Birth. 2019 Jun;46(2):318-325. doi: 10.1111/birt.12408. Epub 2018 Nov 6.
Hospitals that provide maternity care can play an important role in providing or directing mothers to postdischarge breastfeeding support, which improves breastfeeding duration especially when providing multiple support modes. This study described 2007-2015 national trends in postdischarge breastfeeding supports among United States maternity care hospitals.
Data were from the Maternity Practices in Infant Nutrition and Care survey, a biennial census of maternity care hospitals in the United States and territories. Hospitals reported whether they provided nine support types, which we categorized into three support modes: physical contact (eg, return visits), active reaching out (eg, telephone calls), and referrals (eg, to lactation consultants). We calculated prevalence of each support type, each support mode, and providing all three support modes for each survey year and examined trends over 2007-2015. For 2015, we assessed differences by hospital- and area-level characteristics.
Prevalence of providing all three support modes increased from 24% (2007) to 31% (2015). Nearly all (99%) hospitals provided referrals in each survey year. Fewer offered physical contact and active reaching out. However, from 2007 to 2015, the prevalence of physical contact increased from 39% to 46%; active reaching out increased from 54% to 64%. In 2015, smaller and rural hospitals were more likely to provide all three discharge supports.
Prevalence of offering referrals was high, but there is room for improvement in providing physical contact and active reaching out to ensure multiple modes of support are available to help mothers reach their breastfeeding goals.
提供产妇护理的医院可以在提供或指导产妇产后母乳喂养支持方面发挥重要作用，这可以提高母乳喂养的持续时间，尤其是在提供多种支持模式的情况下。本研究描述了 2007 年至 2015 年美国产妇护理医院产后母乳喂养支持的全国趋势。
数据来自母婴营养与护理实践调查，这是一项对美国和领土内产妇护理医院的两年一次普查。医院报告了他们是否提供了九种支持类型，我们将这些支持类型分为三种支持模式：身体接触（例如，回访）、主动联系（例如，电话联系）和转介（例如，向哺乳顾问转介）。我们计算了每个调查年份每种支持类型、每种支持模式以及提供所有三种支持模式的流行率，并研究了 2007 年至 2015 年的趋势。对于 2015 年，我们评估了医院和地区水平特征的差异。
提供所有三种支持模式的比例从 2007 年的 24%增加到 2015 年的 31%。几乎所有（99%）医院在每个调查年份都提供转介。提供身体接触和主动联系的医院较少。然而，从 2007 年到 2015 年，身体接触的比例从 39%增加到 46%；主动联系的比例从 54%增加到 64%。2015 年，较小的和农村的医院更有可能提供所有三种出院支持。
提供转介的比例很高，但在提供身体接触和主动联系方面还有改进的空间，以确保有多种支持模式可供帮助母亲实现母乳喂养目标。
