Trends in Hospital Breastfeeding Policies in the United States from 2009-2015: Results from the Maternity Practices in Infant Nutrition and Care Survey.

Background: Having a written breastfeeding policy that is routinely communicated to staff is important. Furthermore, hospitals seeking the Baby-Friendly designation are required to purchase infant formula at fair market value. We sought to determine the trends of model policies and receipt of free infant formula among hospitals with maternity care in the United States.

Methods: The Maternity Practices in Infant Nutrition and Care (mPINC) survey obtained information, every 2 years, on breastfeeding-related practices and policies from hospitals in the United States. We examined the prevalence of hospitals with a model breastfeeding policy, individual policy elements, and how policies were communicated as well as the receipt of free infant formula from 2009 to 2015. Statistical testing is not included because mPINC is a census.

Results: The proportion of hospitals with a model breastfeeding policy increased from 14.1% in 2009 to 33.1% in 2015. More hospitals incorporated policy elements on limited use of pacifiers (+21.0% points), early initiation of breastfeeding (+15.5% points), and limiting non-breast milk feeds of breastfed infants (+14.1% points). Fewer hospitals disseminated policies by word of mouth (-2.0% points), whereas, more posted policies (+8.1% points). The percent of hospitals not receiving free infant formula increased from 7.4% in 2009 to 28.7% in 2015.

Discussion: While more hospitals in the United States are implementing model breastfeeding policies and not receiving free infant formula, the majority do not adhere to these practices. Hospitals may consider reviewing their policies around infant feeding to improve care for new mothers.