Breastfeeding as a Quality Measure

Abstract

The purpose of this study is to explore the National Quality Strategy (NQS) levers (measurement and feedback, public reporting, learning and technical assistance, and certification) on state and national breastfeeding performance. The research evaluates the NQS levers of measurement and feedback and public reporting using secondary data analysis of publicly reported data from the National Immunization Survey and the Centers for Disease Control and Prevention Breastfeeding Report Cards between 2008 and 2018, the latest years available. Linear regression explores the association between the prevalence of state-level Baby-Friendly hospitals and statelevel breastfeeding rates. Subsequent analyses use event study to test whether state-level Baby-Friendly hospital adoption is associated with higher breastfeeding rates. A 10% increase in Baby-Friendly hospitals at the state level is associated with increased population breastfeeding rates by nearly 5% and a decrease in early formula use (before 2 days of life) by 2% to 9%. Breastfeeding increased by 2% to 5% in the first 2 years following state-level Baby-Friendly initiatives, with subsequent increases up to 10% in the next 4 years. The National Quality Strategy levers of measurement and public reporting combined with

Place of Birth Preferences and Relationship to Maternal and Newborn Outcomes Within the American Association of Birth Centers Perinatal Data Registry, 2007-2020

“…Findings from this study highlight the importance of increased access and choice in place of birth for improving health equity, including decreasing cesarean birth and increasing breastfeeding initiation. Key Words: birthing center, birth equity, birth preferences, maternal outcomes, newborn outcomes F or birthing people of low medical risk and those experiencing an uncomplicated pregnancy, avoidance of unnecessary cesarean birth, 1 successful breastfeeding initiation, 2,3 and self-reported experience of respectful care 4,5 can significantly differ between hospitals and other places of birth. In addition, Black childbearing people face disproportionately higher rates of poor perinatal outcomes across the nation.…”

“…For birthing people of low medical risk and those experiencing an uncomplicated pregnancy, avoidance of unnecessary cesarean birth,1 successful breastfeeding initiation,2,3 and self-reported experience of respectful care4,5 can significantly differ between hospitals and other places of birth. In addition, Black childbearing people face disproportionately higher rates of poor perinatal outcomes across the nation 6.…”

Birth Center Breastfeeding Rates

“…Breastfeeding initiation and duration rates are key health indicators due to their associated health impacts. One measure endorsed by The Joint Commission and the National Quality Forum is the rate of exclusive breastfeeding upon postpartum discharge from a birthing facility, due to its strength of predicting longer-term breastfeeding patterns (Jolles & Hoehn-Velasco, 2021). For people who breastfeed, health impacts include lower risks of postpartum hemorrhage, depression, cardiovascular disease, and many cancers (Louis-Jacques & Stuebe, 2020).…”

Breastfeeding as a Quality Measure: The Appropriate Measure Is Initiation

“…We read with interest the recent report of Jolies and Hoehn-Velasco1 concerning the value of The Joint Commission breastfeeding exclusivity perinatal core measure and Baby-Friendly certification, as an effective quality strategy and associated “lever” driving performance improvement and enhanced population health.…”