Last data update: Nov 11, 2024. (Total: 48109 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Boundy EO[original query] |
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Disaggregation of breastfeeding initiation rates by race and ethnicity - United States, 2020-2021
Marks KJ , Nakayama JY , Chiang KV , Grap ME , Anstey EH , Boundy EO , Hamner HC , Li R . Prev Chronic Dis 2023 20 E114 INTRODUCTION: Although breastfeeding is the ideal source of nutrition for most infants, racial and ethnic disparities exist in its initiation. Surveillance rates based on aggregated data can challenge the understanding and monitoring of effective, culturally appropriate interventions among racial and ethnic subgroups. Aggregated data have historically estimated breastfeeding rates among a few large racial and ethnic groups. We examined differences in breastfeeding initiation rates by disaggregation of data to finer subgroups of race and ethnicity. METHODS: We analyzed births from January 1, 2020, through December 31, 2021, in 48 states and the District of Columbia by using National Vital Statistics System birth certificate data. Data indicate whether an infant received any breast milk during birth hospitalization and include self-reported maternal race and ethnicity. Cross-tabulations of race and ethnicity by breastfeeding initiation were calculated and compared across aggregated and disaggregated categories. RESULTS: The overall prevalence of breastfeeding initiation was 84.0%, ranging from 74.5% (mothers identifying as Black) to 94.0% (mothers identifying as Japanese). The aggregated prevalence of breastfeeding initiation among mothers identifying as Hispanic was 86.8%; disaggregated estimates by Hispanic origin ranged from 82.2% (Puerto Rican) to 90.9% (Cuban). CONCLUSION: Substantial variation in the prevalence of breastfeeding initiation across disaggregated racial or ethnic categories exists. Disaggregation of racial and ethnic data unmasked differences that could reflect variations in cultural practices or systemic barriers to breastfeeding. Understanding why these differences exist could guide public health practitioners' efforts to improve and tailor breastfeeding support. |
Public belief in the maternal health benefits of breastfeeding - United States, 2018 and 2021
Boundy EO , Nelson JM , Li R . Prev Chronic Dis 2023 20 E75 The objective of this study was to better understand US public awareness of maternal health benefits of breastfeeding. Data from the 2018 and 2021 SummerStyles surveys were analyzed to explore public belief in select maternal benefits of breastfeeding. As in 2018, in 2021 a low percentage of respondents believed that breastfeeding protects the mother against breast cancer (23.9%), high blood pressure (15.5%), or type 2 diabetes (15.4%), with male, older, and unmarried respondents less likely to believe in these protective effects. More public awareness of maternal benefits of breastfeeding might help increase demand for breastfeeding-supportive programs and policies. |
Early introduction of complementaryfoods/drinks and milk feeding type in the Special Supplemental Nutrition Program for Women, Infantsand Children (WIC)
Marks KJ , Boundy EO , Nakayama JY , Li R , Hamner HC . Matern Child Nutr 2023 19 (4) e13541 Infants younger than 4 months are not ready for complementary foods/drinks (any solid or liquid other than breast milk or infant formula). Almost half of US infants participate in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition education and support to low-income families. We describe the prevalence of early introduction (<4 months) of complementary foods/drinks and examine the association of milk feeding type (fully breastfed, partially breastfed or fully formula fed) with early introduction of complementary foods/drinks. We used data from 3310 families in the longitudinal WIC Infant and Toddler Feeding Practices Study-2. We described the prevalence of early introduction of complementary foods/drinks and modeled the association of milk feeding type at Month 1 with early introduction of complementary foods/drinks using multi-variable logistic regression. Thirty-eight percent of infants were introduced early to complementary foods/drinks (<4 months). In adjusted models, infants who were fully formula fed or partially breastfed at Month 1 were 75% and 57%, respectively, more likely to be introduced early to complementary foods/drinks compared with fully breastfed infants. Almost two in five infants were given complementary foods/drinks early. Formula feeding at Month 1 was associated with higher odds of early introduction of complementary foods/drinks. There are opportunities to support families participating in WIC to prevent early introduction of complementary foods/drinks and promote child health. |
Patterns in mothers' recollection of health care providers' young child feeding recommendations
McGowan A , Boundy EO , Nelson JM , Hamner HC . J Nutr Educ Behav 2022 54 (11) 1024-1033 OBJECTIVE: Characterize feeding guidance mothers recall receiving from their child's health care provider (HCP). DESIGN: Cross-sectional study of mothers participating in the 2017-2019 National Survey of Family Growth. PARTICIPANTS: US mothers reporting (n = 1,302) information about their youngest child (aged 6 months to 5 years). VARIABLES MEASURED: Weighted percentage of mothers who recalled their child's HCP discussing 6 different feeding topics by demographic characteristics. ANALYSIS: Logistic regression assessing the relationship between recall of feeding guidance and demographics. RESULTS: In this sample, 36.9% of mothers (95% confidence interval, 32.3-41.4) recalled HCPs recommending solid food before 6 months old (34.6% at 4-5 months, and 2.3% before 4 months). Mothers who were older or had a higher education level were more likely than their counterparts to recall their HCP discussing several of the feeding topics examined. CONCLUSION AND IMPLICATIONS: Mothers reported high recollection of early childhood nutrition guidance from their HCP; however, certain topics (eg, appropriate timing of solid food introduction) could be prioritized, and some subpopulations may need additional focus to improve receipt of messages. A better understanding of variability in recall of feeding guidance could provide information for interventions to address barriers to receiving and retaining guidance. |
Donor human milk use in advanced neonatal care units - United States, 2020
Boundy EO , Anstey EH , Nelson JM . MMWR Morb Mortal Wkly Rep 2022 71 (33) 1037-1041 Approximately 50,000 infants are born in the United States each year with very low birthweight (VLBW) (<1,500 g).* Benefits of human milk to infants with VLBW include decreased risk for necrotizing enterocolitis, a serious illness resulting from inflammation and death of intestinal tissue that occurs most often in premature infants, especially those who are fed formula rather than human milk; late-onset sepsis; chronic lung disease; retinopathy of prematurity; and neurodevelopmental impairment (1). When mother's own milk is unavailable or insufficient, pasteurized donor human milk (donor milk) plus a multinutrient fortifier is the first recommended alternative for infants with VLBW (2). CDC's 2020 Maternity Practices in Infant Nutrition and Care (mPINC) survey was used to assess practices for donor milk use in U.S. advanced neonatal care units of hospitals that provide maternity care (3). Among 616 hospitals with neonatal intensive care units (level III or IV units),() 13.0% reported that donor milk was not available for infants with VLBW; however, approximately one half (54.7%) reported that most (80%) infants with VLBW do receive donor milk. Donor milk availability for infants with VLBW was more commonly reported among hospitals with a level IV unit, higher annual birth volume, location in the Midwest and Southwest regions, nonprofit and teaching status, and those designated Baby-Friendly.() Addressing hospitals' barriers to providing donor milk could help ensure that infants with VLBW receive donor milk when needed and help reduce morbidity and mortality in infants with VLBW (1,4). |
Prevalence of delayed cord clamping among U.S. hospitals by facility characteristics
Nakayama JY , Perrine CG , Hamner HC , Boundy EO . Obstet Gynecol 2021 138 (5) 802-804 Delayed cord clamping allows transfusion of placental blood to the newborn in the first minutes after birth.1 For term newborns, this practice increases hemoglobin and iron stores, preventing or delaying iron deficiency, and may improve young children’s development.1,2 It is recommended by the American College of Obstetricians and Gynecologists,3 but its prevalence in the United States is not well-reported. This study describes delayed cord clamping’s prevalence in U.S. hospitals overall and by facility characteristics. |
Implementation of Hospital Practices Supportive of Breastfeeding in the Context of COVID-19 - United States, July 15-August 20, 2020.
Perrine CG , Chiang KV , Anstey EH , Grossniklaus DA , Boundy EO , Sauber-Schatz EK , Nelson JM . MMWR Morb Mortal Wkly Rep 2020 69 (47) 1767-1770 Breastfeeding has health benefits for both infants and mothers and is recommended by numerous health and medical organizations*(,†) (1). The birth hospitalization is a critical period for establishing breastfeeding; however, some hospital practices, particularly related to mother-newborn contact, have given rise to concern about the potential for mother-to-newborn transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (2). CDC conducted a COVID-19 survey (July 15-August 20, 2020) among 1,344 hospitals that completed the 2018 Maternity Practices in Infant Nutrition and Care (mPINC) survey to assess current practices and breastfeeding support while in the hospital. Among mothers with suspected or confirmed COVID-19, 14.0% of hospitals discouraged and 6.5% prohibited skin-to-skin care; 37.8% discouraged and 5.3% prohibited rooming-in; 20.1% discouraged direct breastfeeding but allowed it if the mother chose; and 12.7% did not support direct breastfeeding, but encouraged feeding of expressed breast milk. In response to the pandemic, 17.9% of hospitals reported reduced in-person lactation support, and 72.9% reported discharging mothers and their newborns <48 hours after birth. Some of the infection prevention and control (IPC) practices that hospitals were implementing conflicted with evidence-based care to support breastfeeding. Mothers who are separated from their newborn or not feeding directly at the breast might need additional postdischarge breastfeeding support. In addition, the American Academy of Pediatrics (AAP) recommends that newborns discharged before 48 hours receive prompt follow-up with a pediatric health care provider. |
Maternal race trends in early infant feeding patterns in Hawai'i using newborn metabolic screening-birth certificate linked data 2008-2015
Hayes DK , Boundy EO , Hansen-Smith H , Melcher CL . Hawaii J Health Soc Welf 2020 79 (2) 42-50 Breastfeeding provides optimal nutrition for infants, including short- and longterm health benefits for baby and mother. Maternity care practices supporting breastfeeding after delivery increase the likelihood of exclusive breastfeeding. This study explores trends in early infant feeding practices by maternal race and other characteristics in Hawai'i. Data from a linked 2008-2015 Hawai'i Newborn Metabolic Screening and Birth Certificate file for 128 399 singleton term infants were analyzed. Early infant feeding occurring 24-48 hours after delivery and before discharge was categorized: Early formula feeding; early mixed feeding; and early exclusive breastfeeding. Differences were assessed over time by maternal race and other socio-demographic characteristics. Further assessment of maternal race included a generalized logit model adjusting for maternal age, marital status, county of residence, type of birth attendant, and birth year. Statewide, early exclusive breastfeeding increased from 58.8% in 2008 to 79.1% in 2015 (relative increase=+35%); early mixed feeding declined from 31.1% to 16.0% (relative decrease=-49%) and early formula feeding declined from 10.1% to 4.9% (relative decrease=-51%). Most maternal race subgroups experienced increases in early exclusive breastfeeding and decreases in mixed and formula. Japanese mothers were 2.15 (95%CI=1.90-2.42) and Korean mothers were 1.73 (95%CI=1.37-2.18) times more likely to practice early exclusive breastfeeding compared with white mothers. Several subgroups were less likely to practice early exclusive breastfeeding compared with white mothers. Substantial increases in early exclusive breastfeeding in Hawai'i occurred across all subgroups. Development of culturally appropriate hospital practices, particularly in those with persistently lower estimates, could help improve early exclusive breastfeeding. |
US pediatrician practices on early nutrition, feeding, and growth
Boundy EO , Fisher Boyd A , Hamner HC , Belay B , Liebhart JL , Lindros J , Hassink S , Frintner MP . J Nutr Educ Behav 2019 52 (1) 31-38 OBJECTIVE: Assess pediatrician practices around growth and nutrition for children under 2 years. DESIGN: 2017 cross-sectional survey of a national random sample of the American Academy of Pediatrics members. SETTING: US. PARTICIPANTS: Practicing primary care pediatricians and residents (n=698). MAIN OUTCOME MEASURES: World Health Organization growth chart use, solid food introduction recommendations, healthy behaviors discussion. ANALYSIS: Descriptive statistics were calculated for nutrition-related questions. McNemar tests compared recommendations on the introduction of different solid foods at <6 months; chi-square tests of independence examined outcomes by pediatrician and practice characteristics. RESULTS: Most respondents (82.2%) reported using the World Health Organization growth charts at all well visits. Nearly half (45.3%) recommended solid food introduction at 6 months; 48.2% recommended <6 months. Cereals were more frequently recommended at <6 months than fruits/vegetables or meats (P <.001). Topics most frequently discussed were limiting juice (92.3%), and sugar-sweetened beverages (92.0%), avoiding restrictive and permissive food practices (30.7%), and avoiding food as a reward (29.1%) were least discussed. Pediatricians in hospital/clinic settings discussed healthy behaviors less than group or solo/2-physician practices. CONCLUSIONS AND IMPLICATIONS: For children under 2 years, most pediatricians reported using recommended growth charts and discussing healthy behaviors. Fewer discussed responsive feeding topics. Results for guiding solid food introduction were mixed. Continued efforts to support pediatricians' work could improve the implementation of recommended practices. |
Trends in rooming-in practices among hospitals in the United States, 2007-2015
Barrera CM , Nelson JM , Boundy EO , Perrine CG . Birth 2018 45 (4) 432-439 BACKGROUND: Rooming-in, or keeping mothers and infants together throughout the birth hospitalization, increases breastfeeding initiation and duration, and is one of the Ten Steps to Successful Breastfeeding. METHODS: The Centers for Disease Control and Prevention's (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey is a biennial census of all birth facilities in the United States and its territories. Data from the 2007-2015 mPINC surveys were used to assess trends in the prevalence of hospitals with most (>/=90%) infants rooming-in more than 23 hours per day (ideal practice). Hospital practices among breastfed infants not rooming-in at night and reasons why hospitals without ideal rooming-in practices removed healthy, full-term, breastfed infants from their mothers' rooms were also analyzed. RESULTS: The percentage of hospitals with ideal practice increased from 27.8% in 2007 to 51.4% in 2015. Most breastfed infants who were not rooming-in were brought to their mothers at night for feedings (91.8% in 2015). Among hospitals without ideal rooming-in practices, the percentage removing 50% or more of infants from their mothers' rooms at any point during the hospitalization decreased for all reasons surveyed during 2007-2015; however, in 2015, hospitals still reported regularly removing infants for hearing tests (73.2%), heel sticks (65.5%), infant baths (40.2%), pediatric rounds (35.5%), and infant photos (25.4%). CONCLUSIONS: Hospital implementation of rooming-in increased 23.6 percentage points during 2007-2015. Continued efforts are needed to ensure that all mothers who choose to breastfeed receive optimal lactation support during the first days after giving birth. |
Trends in maternity care practice skin-to-skin contact indicators: United States, 2007-2015
Boundy EO , Perrine CG , Barrera CM , Li R , Hamner HC . Breastfeed Med 2018 13 (5) 381-387 BACKGROUND: Mother-infant skin-to-skin contact (SSC) immediately after birth helps transition infants to the post-uterine environment and increases the likelihood of breastfeeding initiation and duration. This study examines trends in U.S. maternity practices related to SSC, and variations by facility demographics. METHODS: Data were from the Maternity Practices in Infant Nutrition and Care (mPINC) surveys (2007-2015), a biennial assessment of all U.S. maternity facilities. Facilities reported how often patients were encouraged to practice mother-infant SSC for >/=30 minutes within 1 hour of uncomplicated vaginal birth and 2 hours of uncomplicated cesarean birth, and how often routine infant procedures are performed while in SSC. We calculated the percentage of maternity facilities reporting these indicators for >/=90% of patients across the United States for each survey year. Estimates by facility characteristics (size, type, and state) were calculated for 2015 only. RESULTS: The percentage of facilities reporting "Most (>/=90%)" women, which were encouraged to practice early SSC, increased from 2007 to 2015 following both vaginal (40.4% to 83.0%) and cesarean (29.3% to 69.9%) births. The percentage of facilities reporting routine infant procedures were performed "Almost always (>/=90%)," while mother and infant were SSC increased from 16.6% to 49.5% (2007 to 2015) for vaginal births and from 2.2% to 10.7% (2009 to 2015) for cesarean births. Variations in SSC practice by facility type, size, and state were noted. CONCLUSIONS: Significant progress has been made in increasing hospital encouragement of early SSC for both vaginal and cesarean births. Continued efforts to support evidence-based maternity practices are needed. |
Disparities in hospital-reported breast milk use in neonatal intensive care units - United States, 2015
Boundy EO , Perrine CG , Nelson JM , Hamner HC . MMWR Morb Mortal Wkly Rep 2017 66 (48) 1313-1317 Breast milk is the recommended nutrition for infants. For preterm infants, when mother's milk is not available, pasteurized donor milk is recommended (1). Non-Hispanic black mothers are at increased risk for having a preterm birth and for not breastfeeding (2,3); however, it is not known whether demographic disparities exist in the use of breast milk in neonatal intensive care units (NICUs). Data from CDC's 2015 Maternity Practices in Infant Nutrition and Care (mPINC) survey, which does not collect patient-level demographics, were linked to the 2011-2015 U.S. Census Bureau's American Community Survey (ACS)* to examine use of breast milk in NICUs based on demographic makeup of the hospital's postal code area. Among U.S. hospitals with a NICU, the use of mother's own milk and donor milk were examined by the percentage of non-Hispanic black (black) residents in the hospital postal code area, categorized as being above or below the national average (12.3%). In postal codes with >12.3% black residents, 48.9% of hospitals reported using mothers' own milk in ≥75% of infants in the NICU, and 38.0% reported not using donor milk, compared with 63.8% and 29.6% of hospitals, respectively, in postal codes with ≤12.3% black residents. Further investigation is needed to understand variations in breast milk use in NICUs. Targeted efforts to increase breast milk use in hospitals located in postal codes where the percentage of black mothers is above the national average might help ensure more equitable access to breast milk for preterm and other high-risk infants. |
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- Page last updated:Nov 11, 2024
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