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Breastfeeding Initiative

Guidelines and Resources for Hospitals

Medical Professional in hospital room with breastfeeding women in background

California Infant Feeding Guide
A feeding guide for children from birth to one year of age, with a focus on breastfeeding.

In-Hospital Breastfeeding Initiation Data
The California Department of Public Health (CDPH) releases annual in-hospital breastfeeding initiation rates. Hospital staff and administrators can use this information to examine the percentage of women who initiate “exclusive” or “any” breastfeeding at their hospital in comparison to rates at similar hospitals and the state rate.

Hospital Breastfeeding Rates & Reports 
Annual fact sheets and biannual reports on California hospital rates and policies produced by the California WIC Association

Maternity Practices in Infant Nutrition and Care (mPINC) Survey 
The Centers for Disease Control and Prevention (CDC) releases bi-annual Maternity Practices in Infant Nutrition and Care (mPINC) Survey results to all participating hospitals and birth centers in the United States. Each participating facility received a customized mPINC Benchmark Report that addresses barriers to evidence-based maternity care related to breastfeeding. Hospitals are encouraged to utilize their mPINC report to support quality improvement efforts within the maternity care setting.

The Joint Commission’s Perinatal Care Core Measure Set 
The Joint Commission has expanded the mandatory performance measure requirements for accredited hospitals with 300 or more births per year to include the Perinatal Care Core Measure Set that includes exclusive breast milk feeding. The United States Breastfeeding Committee (USBC)  produced a resource entitled "Implementing the Joint Commission Perinatal Core Measure on Exclusive Breast Milk Feeding "

Hospital Infant Feeding Act 
The Hospital Infant Feeding Act (California Health & Safety Code §123366) requires all California hospitals with a perinatal unit to have an infant feeding policy. Policies need to promote breastfeeding and utilize guidance from the Baby-Friendly Hospital Initiative  or the State Department of Public Health Model Hospital Policy Recommendations and must be clearly posted and routinely communicated to staff.

California Health & Safety Codes §123367  Requires that by 2025 all hospitals with a perinatal unit adopt the "Ten Steps to Successful Breastfeeding" per Baby Friendly USA's Baby-Friendly Hospital Initiative , or an alternate process that includes evidenced-based policies and practices with targeted outcomes.

Breastfeeding Model Hospital Policy Recommendations 
These recommendations are designed to give basic information and guidance to perinatal professionals who wish to revise policies that affect the breastfeeding mother. Note: These recommendations are currently under revision.

Model Policy: Payer Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies 
Created by the United States Breastfeeding Committee and the National Breastfeeding Center to identify best practices for supporting coverage of services, pumps and supplies per the Patient Protection and Affordable Care Act (ACA).

Recommended training for general acute care hospitals per California Health and Safety Code 1257.9.  Please contact your local Regional Perinatal Program of California for available trainings, designed to promote exclusive breastfeeding, to be used by administrative and supervisory staff working in hospitals that provide maternity care. Per California Health and Safety Code 1257.9 requirements, CDPH developed a training in 2011 to promote exclusive breastfeeding which is available upon request. Please email wicpumps@cdph.ca.gov for a copy of the training.

1 in 3 mothers stop breastfeeding without hospital support 

Hospital Support for Breastfeeding 
Most hospitals do not fully support breastfeeding . Breastfeeding helps protect against childhood obesity and other illnesses, and lowers medical costs.

Baby-Friendly™ Hospitals in California  
California leads the nation with hospitals achieving the prestigious Baby-Friendly Hospital designation

Baby-Friendly USA 
Baby-Friendly USA, Inc. (BFUSA) is the accrediting body and national authority for the BFHI in the United States. In this capacity, BFUSA is responsible for coordinating and conducting all activities necessary to confer the Baby-Friendly designation and to ensure the widespread adoption of the BFHI in the United States.

The Regional Perinatal Programs of California (RPPC) provide quality improvement resources, consultation, and technical assistance to hospitals and health care providers. This includes promotion of quality hospital breastfeeding policies and related trainings.

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