Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, 4770 Buford Hwy, Atlanta, GA, 30341, USA.
United States Public Health Service, 1101 Wootton Pkwy, Rockville, MD, 20852, USA.
BMC Pregnancy Childbirth. 2024 Jul 12;24(1):475. doi: 10.1186/s12884-024-06672-z.
Experiences during the birth hospitalization affect a family's ability to establish and maintain breastfeeding. The Ten Steps to Successful Breastfeeding (Ten Steps) describe evidence-based hospital policies and practices shown to improve breastfeeding outcomes. We aim to describe hospitals' implementation of the Ten Steps, changes over time, and hospitals' implementation of a majority (≥ 6) of the Ten Steps by hospital characteristics and state.
The biennial Maternity Practices in Infant Nutrition and Care (mPINC) survey assesses all hospitals in the United States (including the District of Columbia and territories) that routinely provide maternity care services. We analyzed data from 2018, 2020, and 2022 survey cycles to describe trends in the prevalence of hospitals implementing maternity care policies and practices that are consistent with the Ten Steps. Differences were calculated using the absolute difference in percentage-points between 2018 and 2022.
Between 2018 and 2022, the percentage of hospitals that implemented Step 2: Staff Competency and Step 5: Support Mothers with Breastfeeding increased 12 and 8 percentage points, respectively. The percentage of hospitals that implemented Step 6: Exclusive Breastfeeding Among Breastfed Infants was 7 percentage points lower in 2022 than 2018. Implementation of the remaining seven steps did not change by more than 5 percentage points in either direction between 2018 and 2022. Nationally, the percentage of hospitals that implemented ≥ 6 of the Ten Steps increased from 44.0% in 2018 to 51.1% in 2022. Differences were seen when comparing implementation of ≥ 6 of the Ten Steps by hospital characteristics including state, hospital size, and highest level of neonatal care offered.
Nationally, maternity care policies and practices supportive of breastfeeding continued to improve; however, certain practices lost progress. Differences in implementation of the Ten Steps were observed across states and by certain hospital characteristics, suggesting more work is needed to ensure all people receive optimal breastfeeding support during their delivery hospitalization.
分娩住院期间的经历会影响家庭建立和维持母乳喂养的能力。《成功母乳喂养的十步》（Ten Steps）描述了经过验证的基于证据的医院政策和实践，这些政策和实践已被证明可以改善母乳喂养的结果。我们旨在描述医院实施 Ten Steps 的情况、随时间的变化，以及根据医院特征和州的不同，实施大多数（≥6）Ten Steps 的情况。
两年一次的母婴营养与护理实践调查（mPINC）评估了美国（包括哥伦比亚特区和领土）所有常规提供产妇护理服务的医院。我们分析了 2018 年、2020 年和 2022 年调查周期的数据，以描述与 Ten Steps 一致的医院实施产妇保健政策和实践的流行趋势。差异通过 2018 年和 2022 年之间百分比点的绝对差值计算得出。
在 2018 年至 2022 年期间，实施步骤 2：员工能力和步骤 5：支持母乳喂养的母亲的医院比例分别增加了 12 和 8 个百分点。2022 年实施母乳喂养婴儿中完全母乳喂养比例比 2018 年低 7 个百分点。在 2018 年至 2022 年期间，其他七个步骤的实施方向没有超过 5 个百分点的变化。全国范围内，实施 Ten Steps 中≥6 项的医院比例从 2018 年的 44.0%增加到 2022 年的 51.1%。在比较各州实施≥6 项 Ten Steps 的情况时，观察到了差异，包括州、医院规模和提供的新生儿护理水平。
在全国范围内，支持母乳喂养的产妇保健政策和实践继续得到改善；然而，某些实践失去了进展。在各州和某些医院特征方面观察到实施 Ten Steps 的差异，这表明需要做更多的工作来确保所有产妇在分娩住院期间都能得到最佳的母乳喂养支持。
