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J Pediatr. 2019 Oct 10. pii: S0022-3476(19)31122-9. doi: 10.1016/j.jpeds.2019.08.059. [Epub ahead of print]

Outcomes from the Centers for Disease Control and Prevention 2018 Breastfeeding Report Card: Public Policy Implications.

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Department of Pediatrics, Newton-Wellesley Hospital, Newton, MA. Electronic address:
Department of Pediatrics, Newton-Wellesley Hospital, Newton, MA.
Department of Pediatrics, Massachusetts General Hospital, Boston, MA.



To compare the impact of Baby-Friendly designation vs rates of in-hospital breastfeeding initiation on breastfeeding outcomes at 3, 6, and 12 months postdischarge.


Breastfeeding outcome data from the 2018 Centers for Disease Control (CDC) Breastfeeding Report Card were used as a basis for determining outcomes from the corresponding 2015 birth cohort. Linear regression models were used to determine the strength of association of breastfeeding initiation and Baby-Friendly hospital penetrance and attainment of postdischarge breastfeeding rates. All hospital births from all 50 states, 3 territories, and the District of Columbia were included in the study.


Statewide breastfeeding initiation rates were positively associated with targeted breastfeeding outcomes. Similar associations were not found for Baby-Friendly hospital designation penetrance.


To attain the Healthy People 2020 breastfeeding objectives, future public policy initiatives should consider the interaction of population demographics, individual hospital programs, and public health strategies used to support breastfeeding in states reporting high breastfeeding initiation rates.


Baby-Friendly; breastfeeding

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