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December 05, 2019

Hospital-based breastfeeding initiatives reduce early infant deaths

New research refutes suggestion that initiatives increase risk of sudden unexpected infant deaths

Parenting Breastfeeding
Baby-friendly hospital initiatives breastfeeding Source/Image licensed from Ingram Images

Increasing the implementation of hospital-based breastfeeding initiatives reduces the rates of infant deaths in the first six days after birth, a new study finds, refuting the belief that they increase the risk of early death.

The pressures on a new mom can be overwhelming, especially the push to exclusively breastfeed. 

The benefits of breastfeeding are well-documented, but it doesn't come easily to every mother and baby. And the amount of intervention hospital staff should take in those first few days has been a point of debate.

A new study published in the Journal of Pediatrics suggests that increasing the implementation of hospital-based breastfeeding initiatives reduces the rates of infant deaths in the first six days, refuting claims that the initiatives actually increase the risk of early death.

The study, co-authored by Dr. Lori Feldman-Winter, of Children's Regional Hospital at Cooper University Health Care, analyzed trends in the implementation of the Baby-Friendly Hospital Initiative (BFHI) and skin-to-skin care using data from the U.S. Centers for Disease Control and Prevention. 

"We now recognize that evidence-based maternity care practices to support breastfeeding are associated with a decreased risk of neonatal death," Feldman-Winter said.

The World Health Organization and The United Nations Children's Fund launched BFHI in 1991 to "implement practices that protect, promote and support breastfeeding." Skin-to-skin, care also known as Kangaroo Care, refers to the practice of having mothers hold their babies to her their bare chests as much as possible.

Researchers examined the percentage of births in baby-friendly hospitals from 2004 to 2016 in both the U.S. and Massachusetts populations. They also analyzed data on skin-to-skin care from 2007 to 2015. They compared their findings to data on sudden unexpected infant death (SUID) recorded by the U.S. Centers for Disease Control and Prevention WONDER system and the Massachusetts Department of Public Health.

Researchers found that the percentage of births in BFHI hospitals increased, as did the percentage of babies experiencing skin-to-skin care in the first hour after birth. At the same time, deaths due to sudden unexpected infant death, including asphyxia, within the first six days after birth decreased. 

"These data come as welcome news, and should reassure us that these initiatives are not resulting in any increase in infant death – that in fact, just the opposite is true," said lead author Dr. Melissa Bartick, an internist at Cambridge Health Alliance and assistant professor of medicine at Harvard Medical School.

Concerns about such interventions being deadly originated from a popular opinion piece that cited Massachusetts' infant mortality data, Bartick said. It was first published in medical literature in 2016 and again as part of a 2018 national study. 

But the latest study found that less than 1% of SUIDs that occurred during the first month of life happened during the first six days. According to Bartick, the SUIDS risk is highest in the first two-to-four months of life.

In addition, as more hospitals in Massachusetts began implementing skin-to-skin care, no deaths from asphyxia were recorded. Skin-to-skin care approach is used regardless of feeding method.

"Increasing rates of breastfeeding initiatives and skin-to-skin care" are associated with "decreasing SUID prevalence in the first six days after birth in the U.S. and Massachusetts," the authors wrote in the study.

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