News article

Joint Commission approves breastfeeding measure

July 31, 2009

Oakbrook Village, IL–In a major step forward for public health, the group that accredits US hospitals will hold maternity hospitals accountable for the quality of care they provide to breastfeeding mothers and babies.

“This is one huge step for breastfeeding in the US,” says Melissa Bartick, MD, Chair of the Massachusetts Breastfeeding Coalition. “This move will really help moms get the support they need in order to reach their own breastfeeding goals.” Multiple studies have shown that maternity care makes a huge difference for breastfeeding success.

The new measure, which is part of the Joint Commission’s new Perinatal Care measure set, requires hospitals to report the rate of exclusive breastfeeding among mothers who intend to breastfeed. The measure does not affect women who do not plan to breastfeed.

A recent CDC survey found that many US hospital routines undermine mothers who want to breastfeed. Giving formula to healthy breastfed infants was common, despite evidence from multiple studies that babies who receive formula in the hospital wean earlier than those who do not.

More than half of US mothers wean their babies earlier than they want to, and their struggles begin with poor care during their maternity stay. “Mothers deserve high-quailty support,” Bartick said. This measure is expected to encourage hospitals to adopt a variety of measures to support breastfeeding mothers and infants. For example, breastfeeding in the first hour of life, skin to skin contact, and rooming-in all help promote exclusive breastfeeding.

The exclusive breastfeeding measure was pioneered as part of a quality improvement effort in California, where public health officials found huge differences in exclusive breastfeeding rates from hospital to hospital. In some cases, nearly all breastfed infants were being supplemented with formula. In the top ranked hospitals, including San Francisco General Hospital, fewer than 10% of breastfed infants received supplements. Public reporting of differences in formula use has led hospitals to review their routines and improve quality of care.

The exclusive breastfeeding measure is one of 5 indicators that comprise the new perinatal core measure set. Other indicators include rates of cesarean section, elective delivery before 39 weeks, use of steroids for women at risk for preterm birth, and health care-associated infections in newborns.

The Joint Commission accredits US hospitals, and their measures have a strong influence on quality improvement priorities. Data collection is expected to begin in April 2010. To read more, go to the Joint Commission’s page.