Rachel West

MDS 4983
@01269867
Breastfeeding Duration and Support in the United States
Evidence from the CDCs 2014 Breastfeeding Report Card
confirms that breastfeeding rates continue to rise in the United States.
This is beneficial to new mothers, babies, families, and even
communities. Breastfeeding duration is often dependent on a number
of factors. Age, socioeconomic status, education level, ethnicity, health
status, and access to lactation support often determine the duration of
time that a mother breastfeeds. Using research obtained from the
CDCs Breastfeeding Report Cards from 2009-2014, I will determine
breastfeeding rates of infants at 6 months and 12 months over the
past five years. Additionally, I will identify 3 major types of
breastfeeding support that influence breastfeeding duration and
patterns.
The American Academy of Pediatrics released a policy statement
about breastfeeding in the Official Journal of the American Academy of
Pediatrics entitled Breastfeeding and the Use of Human Milk. In this
statement, the AAP recommends exclusive breastfeeding for about
the first six months of a baby's life, followed by breastfeeding in
combination with the introduction of complementary foods until at
least 12 months of age, and continuation of breastfeeding for as long
as mutually desired by mother and baby (Eidelman et al). The policy
statement also outlined the benefits of breastfeeding.
Breastfeeding decreases the likelihood that a baby will develop
ear infections, diarrhea, respiratory problems, allergies, child leukemia,
neurodevelopmental issues, obesity, diabetes, and a number of other
infectious diseases. Breastfeeding is beneficial to the mother because
it helps her return to her pre-pregnancy weight faster, have increased
child spacing, experience less post-partum depression and have a
reduced risk of breast and ovarian cancer. New mothers also
experience less postpartum bleeding, because the hormones that
promote breastfeeding also help the uterus to contract.
For the family, breastfeeding facilitates bonding experiences. For
the community, breastfeeding helps promote healthy and happy
citizens. Breastfeeding is undoubtedly cost effective as well. It also
helps the environment by saving water, conserving energy for
manufacturing, and by not polluting the environment with waste
(garbage) or air pollution from manufacturing. Moreover, there is never
a concern about the risk of contamination from bacteria or other
substances because it is always fresh, and at the perfect temperature.
(Eidelman et al.)
The CDC generated their Breastfeeding Report Cards using data
obtained from the National Immunization Survey (NIS). This survey

uses random-digit dialing to survey households with children aged 1935 months. Since January 2003, the National Immunization Survey asks
all respondents breastfeeding questions. The Council of American
Survey and Research Organizations response rates for the landline
samples of the National Immunization survey are consistently over
60%.
In 2009, 73.9% of all households sampled reported ever
breastfeeding their infant. 43.4% of households sampled reported
breastfeeding at 6 months, while only 13.6% reported exclusive
breastfeeding at 6 months. 22.7% of households sampled reported
breastfeeding at 12 months. In 2010, 75% of all households sampled
reported ever breastfeeding their infant. 43% of households sampled
reported breastfeeding at 6 months, while only 13.3% reported
exclusive breastfeeding at 6 months. 22.4% of households sampled
reported breastfeeding at 12 months. In 2011, 74.6% of all households
sampled reported ever breastfeeding their infant. 44.3% of households
sampled reported breastfeeding at 6 months, while only 14.8%
reported exclusive breastfeeding at 6 months. 23.8% of households
sampled reported breastfeeding at 12 months. In 2012, 76.9% of all
households sampled reported ever breastfeeding their infant. 47.2% of
households sampled reported breastfeeding at 6 months, while only
16.3% reported exclusive breastfeeding at 6 months. 25.5% of
households sampled reported breastfeeding at 12 months. In 2013,
76.5% of all households sampled reported ever breastfeeding their
infant. 49% of households sampled reported breastfeeding at 6
months, while only 16.4% reported exclusive breastfeeding at 6
months. 27% of households sampled reported breastfeeding at 12
months. Finally, in 2014, 79.2% of all households sampled reported
ever breastfeeding their infant. 49.4% of households sampled reported
breastfeeding at 6 months, while 18.8% reported exclusive
breastfeeding at 6 months. 26.7% of households sampled reported
breastfeeding at 12 months. (CDC)
A few trends are evident in the data from the CDCs annual
Breastfeeding Report Cards. First of all, despite the AAPs
recommendations of exclusive breastfeeding for the first 6 months, the
percentage of mothers exclusively breastfeeding at 6 months is quite
low. Although, from 2009-2014, the percentage of exclusive
breastfeeding at 6 months grew from 13.3% in 2010, to 18.8% in 2014.
This suggests that efforts educate mothers on the benefits of exclusive
breastfeeding for 6 months are, in fact, working.
Another trend evident in the data is that overall; the percentage
of households sampled that reported ever breastfeeding their infant
has increased from 73.9% in 2009 to 79.2% in 2014. This is very
promising. Additionally, the percentage of households that reported
breastfeeding at 12 months has increased from 22.4% in 2010 to
26.7% in 2014. This indicates that mothers are recognizing the benefits

of breastfeeding long-term both for themselves and for their babies,

and choosing to continue to breastfeed. Finally, the percentage of
households that reported any breastfeeding at 6 months is on the rise
as well, from 43% in 2010 to 49% in 2014.
Each of the individual trends found within the data indicate that
breastfeeding rates and durations are increasing. However, with the
obvious benefits of breastfeeding, why are mothers still opting out or
shortening the duration of time they breastfeed? Of course, some
women face chronic diseases or physical illnesses/ disabilities that
disallow them to breastfeed. However, among women who are
physically able to breastfeed, what role does the access to various
kinds of breastfeeding support play in determining their breastfeeding
duration?
Although the CDCs Breastfeeding Report Cards identify five
types of breastfeeding support in the United States, I will focus
specifically on the number of state health department full time
employees dedicated to breastfeeding, the average mPINC (Maternity
Practices in Infant Nutrition and Care) score, and the percent of live
births occurring at facilities designated as Baby Friendly. The number of
state health department full time employees dedicated to
breastfeeding was 79.79 in 2009, 96.79 in 2010, 125.06 in 2011, 135
in 2012, and unfortunately unknown in 2013 and 2014. The average
mPINC score was 63 in 2009, 65 in 2010, 65 in 2011, 70 in 2012, 75 in
2013, and 75 in 2014. The percent of live births occurring at facilities
designated as Baby Friendly was 2.87% in 2009, 3.78% in 2010, 4.53%
in 2011, 6.22% in 2012, 7.15% in 2013, and 7.79 in 2014. (CDC)
The trends found in breastfeeding support from 2009-2014 are
positive. The number of state health department full time employees
dedicated to breastfeeding increased from 79.79 in 2009 to 135 in
2012. Although the data is unavailable for 2013 and 2014, I believe it
is safe to assume that the number of employees grew. The average
mPINC score increased from 63 in 2009 to 75 in 2014 and the percent
of live births occurring at facilities designated as Baby Friendly
increased from 2.87% in 2009 to 7.79% in 2014.
As breastfeeding support continues to rise, the number of babies
ever breastfed, breastfed at 6 months, breastfed exclusively at 6
months, and breastfed at 12 months continues to rise as well. This
positive correlation is extremely evident in the data that I was able to
obtain from the CDCs annual Breastfeeding Report Cards. Although
breastfeeding rates and durations continue to rise in the United States,
it is still very important for breastfeeding support to grow and
education to increase. It is my hope that eventually all mothers, who
are physically capable of breastfeeding, breastfeed exclusively for 6
months, and continue with a combination of complementary foods up
to 12 months, or longer. With adequate support and education,

mothers and babies will have the means to prosper in great health and
wellness for years to come.

Works Cited
"Breastfeeding Report Card 2009-20014." Centers for Disease Control
and Prevention. Centers for Disease Control and Prevention, 31
July 2014. Web. 24 Apr. 2015.
Eidelman, Arthur I. "Breastfeeding and the Use of Human Milk: An
Analysis of the
American Academy of Pediatrics 2012 Breastfeeding
Policy Statement."
Breastfeeding Medicine 7.5 (2012): 323-24.
Web. 20 April 2015.