The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures for the 2015-2017 grant cycle. Performance Measure 4 is the percent of infants who were ever breastfed. This evidence brief points to a selection of resources for state MCH programs on increasing the percent of infants breastfed, with an emphasis on evidence based information.
The Title V Maternal and Child Health Services Block Grant to States Program guidance1 defines the significance of this goal as follows:
Advantages of breastfeeding are indisputable. The American Academy of Pediatrics recommends all infants (including premature and sick newborns) exclusively breastfeed for about six months as human milk supports optimal growth and development by providing all required nutrients during that time. Breastfeeding strengthens the immune system, improves normal immune response to certain vaccines, offers possible protection from allergies, and reduces probability of SIDS. Research demonstrates breastfed children may be less likely to develop juvenile diabetes; and may have a lower risk of developing childhood obesity, and asthma; and tend to have fewer dental cavities throughout life. The bond of a nursing mother and child is stronger than any other human contact. A woman's ability to meet her childs nutritional needs improves confidence and bonding with the baby and reduces feelings of anxiety and postnatal depression. Increased release of oxytocin while breastfeeding, leads to a reduction in post-partum hemorrhage and quicker return to a normal sized uterus over time, mothers who breastfeed may be less likely to develop breast, uterine and ovarian cancer and have a reduced risk of developing osteoporosis.
Read More about Performance Measure 4
Performance Measure 4
A) Percent of infants who are ever breastfed and B) Percent of infants breastfed exclusively through 6 months
To increase the proportion of infants who are breastfed and who are breastfed at six months
Numerator: A) Number of infants who were ever breastfed and B) Number of infants breastfed exclusively through 6 months
Denominator: A) All infants born in a calendar year and B) All infants born in a calendar year
Healthy People 2020 Objective
Related to Maternal, Infant, and Child Health (MICH) Objective 21.1: Increase the proportion of children who are ever breastfed (Baseline: 74% in 2006, Target: 81.9%)
Related to Maternal, Infant, and Child Health (MICH) Objective 21.5: Increase the proportion of children who are breastfed exclusively (Baseline: 14.1% in 2006, Target: 25.5%)
Data Sources and Data Issues
CDCs National Immunization Survey (NIS)
Data and Statistics
- American Academy of Pediatrics: Breastfeeding Initiatives. Webinars, news updates, and initiatives.
- Centers for Disease Control and Prevention: Breastfeeding. Recommendations, data and statistics, research, publications, resources, policies, promotion and support.
- La Leche League International. Breastfeeding and the law, support services, publications and resources for mothers and health care providers.
- Surgeon Generals Call to Action to Support Breastfeeding.
Surgeon Generals 2011 Call to Action and breastfeeding resources for mothers and employers.
- United States Breastfeeding Committee. Breastfeeding news, legislative action, resources, and publications.
Best practices guide for implementation of newborn exclusive breast milk feeding in electronic health records. (2014).
Implementing the Joint Commission Perinatal Care core measure on exclusive breast milk feeding, 2nd rev. ed. 2013.
- Association of Maternal and Child Health Programs (AMCHP). 2013. State opportunities and strategies for breastfeeding promotion through the Affordable Care Act. Washington, DC: Association of Maternal and Child Health Programs.
- Association of State and Territorial Health Organizations: Breastfeeding in the Workplace and Hospitals. This web page links to resources and case studies that provide examples of how state health agencies have effectively supported breastfeeding in the workplace and hospitals.
- Baby-Friendly USA (BFUSA). BFUSA is the U.S. implementation organization for the Baby Friendly Hospital Initiative, the UNICEF and the World Health Organization collaboration promoting 10 evidence-based steps that hospitals should use to support breastfeeding.
- Centers for Disease Control and Prevention. 2013. Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to support breastfeeding mothers and babies. Atlanta, GA: Centers for Disease Control and Prevention.
- Chung M, Ip S, Yu W, Raman G, Trikalinos T, DeVine D, Lau J. 2008. Interventions in primary care to promote breastfeeding: A systematic review. Rockville, MD: Agency for Healthcare Research and Quality.
- Guise JM, Palda V, Westhoff C, Chan BK, Helfand M, Lieu TA. 2003. The effectiveness of primary care-based interventions to promote breastfeeding: Evidence review and meta-analysis for the U.S. Preventive Services Task Force. Annals of Family Medicine 1(2): 70-78. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.
- National Institute for Children's Health Quality: Breastfeeding. Information for professionals on breastfeeding promotion initiatives such as Best Fed Beginnings, Texas Breastfeeding Learning Collaborative, and New York State Breastfeeding Quality Improvement in Hospitals, all of which focus on helping hospitals improve breastfeeding rates.
- Pate B. 2009. A systematic review of the effectiveness of breastfeeding intervention delivery methods. Journal of Obstetric, Gynecologic and Neonatal Nursing 38(6): 642-653. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.
Related NCEMCH Resources
1Health Resources and Services Administration. 2014. Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, Appendix F, p. 77.
Percent of Infants Breastfed: Evidence Brief, 1st ed. (November 2014).
Author: Beth DeFrancis, M.L.S., NCEMCH