Background: Breastfeeding rates among low-income infants lag behind national rates. Policies such as the Baby-Friendly Hospital Initiative (BFHI) improve breastfeeding and may benefit low-income populations such as those who participate in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A recent effort exists to increase the number of Baby-Friendly designated hospitals in Los Angeles County (LAC). Research aim: This study aimed to determine whether the BFHI effort has had a beneficial effect on Baby-Friendly hospital practices in LAC hospitals and to determine if birthing hospitals' Baby-Friendly designation status is associated with breastfeeding outcomes among WIC-participating children in LAC.
Methods: Data came from the Los Angeles County WIC Survey (2008, 2011, 2014), which is conducted on a random sample of approximately 5,000 WIC families living in LAC. The prevalence of three Baby-Friendly hospital practices was examined between 2008 and 2014. Logistic regression was used to examine the association of birthing hospitals' Baby-Friendly designation status with any breastfeeding and exclusive breastfeeding at 1, 3, and 6 months.
Results: The rates of Baby-Friendly hospital practices have improved since 2008. Although no association existed with rates of any breastfeeding, being born in a hospital designated Baby-Friendly or in the process of obtaining this designation was significantly associated with an increased odds of exclusive breastfeeding at 1 and 3 months.
Conclusion: The BFHI may help achieve recommended exclusive breastfeeding rates, especially for low-income populations. Additional strategies are needed to support low-income mothers in LAC with all levels of breastfeeding.
Keywords: Baby-Friendly Hospital Initiative; Infants; Special Supplemental Nutrition Program for Women; and Children; breastfeeding; breastfeeding duration; breastfeeding practices; exclusive breastfeeding.