Breastfeeding Center

Boston, MA, United States

Breastfeeding Center

Boston, MA, United States
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Burnham L.,Breastfeeding Center | Buczek M.,Christ House | Braun N.,Breastfeeding Center | Feldman-Winter L.,Rowan University | And 3 more authors.
Journal of Human Lactation | Year: 2014

Background: Infant feeding data are often collected retrospectively through maternal report. Validation studies show that maternal report of initiation and duration of any breastfeeding is accurate but that report of duration of exclusive breastfeeding may be less accurate. Objective: This study aimed to compare infant feeding data collected longitudinally throughout the first 6 months of life with maternal report of duration of exclusive breastfeeding collected 2 years postpartum. Methods: Infant feeding data were collected prospectively throughout the first 6 months of life from medical records and maternal report, including maternal 24-hour recall. At 2 years postpartum, we asked mothers of these same infants how long they exclusively breastfed their infants. Their responses were compared to the prospectively collected data. Simple and multiple linear regressions tested for any significant predictors of the difference between the prospectively collected data and maternal report at 2 years. Results: Of the 292 mothers included in the final analysis, only 88 (30.1%) mothers reported a duration of exclusive breastfeeding at 2 years postpartum that matched the prospectively collected data. Sixty-four women reported exclusively breastfeeding for the recommended 6 months (21.9%), but according to the prospectively collected data, only 2 women (0.7%) breastfed exclusively through 6 months. The median difference between the prospectively collected data and maternal report at 2 years was 1 month (IQR, 0-4). Conclusion: In this sample of mothers, report of exclusive breastfeeding practices 2 years after birth was often inaccurate and mothers tended to overestimate duration. © The Author(s) 2014.

Merewood A.,Breastfeeding Center | Grossman X.,Boston University | Cook J.,Boston University | Sadacharan R.,Boston University | And 2 more authors.
Journal of Human Lactation | Year: 2010

The World Health Organizations International Code of Marketing of Breast-Milk Substitutes, as well as most major medical authorities, opposes hospital-based distribution of free infant formula at discharge. The goal of this cross-sectional telephone survey of 3209 US maternity sites, conducted from 2006 to 2007, was to determine the extent of this practice. It was found that 91% of hospitals distributed formula sample packs, and a trend toward discontinuation of the practice was statistically significant (P <.001). It was concluded that most US hospitals distribute infant formula samples, in violation of the WHO Code and the recommendations of organizations including the US Government Accountability Office, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention. © Copyright 2010 International Lactation Consultant Association.

Sadacharan R.,Breastfeeding Center | Grossman X.,Breastfeeding Center | Sanchez E.,Breastfeeding Center | Merewood A.,Boston Medical Center
Pediatrics | Year: 2011

OBJECTIVE: To describe trends in the proportion of US hospitals that distribute industry-sponsored formula sample packs between 2007 and 2010. METHODS: This is a follow-up of a 2007 study. In 2007, we surveyed all 50 US states to determine the proportion of hospitals that distributed infant formula samples to new mothers. In 2010, we selected the 10 best-record and 10 worst-record states with regard to industrysponsored formula sample-pack distribution in 2007. We called all hospitals in these 20 states and asked if the maternity service distributed a "formula company-sponsored diaper discharge bag" to new mothers. We also recorded the respondent's job title. RESULTS: We contacted 1239 hospitals in 20 states. In 2007, 14% of these hospitals were sample-pack-free. In 2010, 28% of the same hospitals were sample-pack-free; the proportion of sample-pack-free hospitals per state ranged from 0% (5 states) to 86% (Rhode Island). In the 10 best-record states, the weighted proportion of sample-pack-free hospitals increased by a mean difference of 18% between 2007 and 2010 (P < .0001). In the 10 worst-record states, the weighted proportion of sample-pack-free hospitals increased by a mean difference of 6% (P < .01). CONCLUSION: Most US hospitals continue to distribute industrysponsored formula sample packs, but trends indicate a significant change in practice; increasing proportions of hospitals eliminate these packs. Change was more significant in states where higher proportions of hospitals had already eliminated packs in 2007. Copyright © 2011 by the American Academy of Pediatrics.

Parker M.,Boston University | Burnham L.,Breastfeeding Center | Cook J.,Boston University | Sanchez E.,Breastfeeding Center | And 2 more authors.
Journal of Human Lactation | Year: 2013

Background: Mothers of preterm and sick infants admitted to the neonatal intensive care unit (NICU) often encounter more difficulties with breastfeeding than mothers of healthy term newborns. The extent to which Baby-Friendly designation is associated with breastfeeding rates for NICU infants over time is unknown. Objective: This study aimed to determine the rate of breastfeeding initiation and continuation in a US, inner-city, level 3 NICU 10 years after Baby-Friendly designation. Methods: We compared the rate of breastfeeding initiation and continuation among breastfeeding-eligible mothers with infants admitted to the Boston Medical Center NICU in 1999 and 2009, using chi-square tests. Results: Breastfeeding initiation increased from 74% in 1999 to 85% in 2009 (P = .04). Any breast milk at 2 weeks of age increased from 66% to 80% (P = .05), and exclusive breastfeeding at 2 weeks remained stable between 1999 and 2009. Breastfeeding initiation increased from 68% to 86% among black mothers from 1999 to 2009 (P = .01). Conclusion: Improvement in breastfeeding initiation and any breastfeeding at 2 weeks of age continued 10 years after Baby- Friendly designation among mothers with NICU infants in a US, inner-city, level 3 NICU. © 2013 The Author(s).

Feldman-Winter L.,Cooper University Hospital | Grossman X.,Boston University | Palaniappan A.,Cooper University Hospital | Kadokura E.,Breastfeeding Center | And 3 more authors.
Journal of Human Lactation | Year: 2012

Background: Most US hospitals distribute industry-sponsored formula sample packs. No research has examined outcomes associated with sample pack removal as part of a hospital intervention to eliminate sample distribution postpartum. Objective: To examine prospectively hospital-based and breastfeeding outcomes associated with removal of industry-sponsored formula sample packs from the hospital. Methods: We enrolled mothers postpartum at Cooper University Hospital, an urban New Jersey hospital, in 2009-2010. For the first 6 months, all women received industry-sponsored formula samples packs (control group); for the next 6 months, all postpartum women received hospital-sponsored bags with no formula at source (intervention group). Research assistants blinded to the design called subjects weekly for 10 weeks to determine feeding practices. Results: We enrolled 527 breastfeeding women (284 control; 243 intervention). At 10 weeks postpartum, 82% of control and 36% of intervention women (P < .001) reported receiving formula in the "diaper discharge bag." Kaplan-Meyer curves for any breastfeeding showed the intervention was associated with increased breastfeeding (P = .03); however, exclusive breastfeeding was not significantly different between intervention and controls (P = .46). In post hoc analysis, receiving no take-home formula in bottles from the hospital was associated with increased exclusive breastfeeding in control (P = .02) and intervention (P = .03) groups at 10 weeks. Conclusion: Although the hospital-branded replacement contained no formula at source, many women reported receiving bottles of formula from the hospital. Change in practice to remove industry-sponsored formula sample packs was associated with increased breastfeeding over 10 weeks, but the intervention may have had a greater impact had it not been contaminated. © The Author(s) 2012.

Coit J.,Breastfeeding Center | Grossman X.,Boston University | Buczek M.,Breastfeeding Center | Feldman-Winter L.,Boston University | Merewood A.,Boston University
Journal of Human Lactation | Year: 2012

Background: Introducing solids foods to infants before 6 months has been associated with adverse long-term health outcomes. Studies and surveys frequently use maternal report to identify the age when infants start solid foods. Objective: To address the accuracy of maternal report at 1 year postpartum regarding introduction of solid foods. Methods: Between 2008 and 2009, the authors enrolled mothers of healthy term singletons at an urban Boston hospital within 72 hours of giving birth. We called mothers monthly for 6 months and asked if they had given their baby solid foods in the previous month. At 1 year, we contacted mothers again and asked when they first gave solid foods; answers at 1 year were compared with the data collected monthly. Results: The authors analyzed data on 157 women, all of whom had, according to monthly responses, started solid foods before 6 months. At 1 year, only 14% (22/157) of reports matched data recorded monthly. Although 100% of women introduced solids before 6 months, at 1 year, 41.4% reported starting solids at 6 months. Conclusions: Among women who started feeding solids before 6 months, most did not give an accurate response at 1 year. Most said they started giving solids later than they did. Maternal report may not be the best way to collect such data, and health outcomes based on such data may be biased toward the null. © The Author(s) 2012.

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