Wagner

Background. Our objective was to improve breastfeeding initiation rates at an urban medical center. Methods. A breastfeeding educational program for health care providers was developed and implemented in 1995. The outcome variable of interest was the change in breastfeeding initiation rate during 2 periods, 1993-1994 and 1996 to 1999, stratified by weight (>2,000, 1,500 to 2,000, and <1,500 g). Results. The breastfeeding initiation rate in 1996 to 1999 for all mothers of newborns admitted to the hospital was 47.1% (4,107/8,724), compared with the 1993-1994 rate of 18.9% (816/4,315). During the second period, the breastfeeding rate among mothers of infants <1,500 g was 60.8% (468/770), compared with 19.2% (56/293) during the earlier study period. Stratified by weight, the greatest improvement in rates of breastfeeding initiation and at discharge was seen with mothers of preterm infants. Conclusion. A breastfeeding educational program that interfaced with medical staff and mothers at an urban medical university was associated with increased rates of breastfeeding initiation. From the Division of Neonatology and the Division of Pediatric Epidemiology and Health Systems Research, Department of Pediatrics, Children’s Hospital, Medical University of South Carolina, Charleston. Reprint requests to Carol L. Wagner, MD, Medical University of South Carolina, 165 Ashley Ave, PO Box 250917, Charleston, SC 29425. KEY POINTS • Breastfeeding rates in the Southeast remain significantly lower than those in other regions of the United States. • Educational programs that include mothers and health care providers are effective in improving rates of breastfeeding. • The acknowledgement of the importance of human milk for infant health and development during prenatal consultations appears to play a role in improving rates of breastfeeding ini-