Results of CDC funded Breastfeeding Initiative Featured in Prestigious Pediatrics Journal

–80% of Participating Hospitals Achieve Baby-Friendly Status—

— Cooper Physician Served as National Faculty Chair for Initiative–

A report on the highly successful National Institute for Children’s Health Quality (NICHQ)-led Best Fed Beginnings initiative is featured in the June online edition of the prestigious Pediatrics journal. The piece—Best Fed Beginnings: A Nationwide Quality Improvement Initiative to Increase Breastfeeding—features insights and analysis on the initiative’s major achievements, including driving 80 percent of participating hospitals to achieve “Baby-Friendly” status.

Starting in October 2011, NICHQ engaged 90 hospitals, using the principals of quality improvement, to make systemic changes to adopt the Ten Steps of Successful Breastfeeding, a requirement to achieve Baby-Friendly status. By April 2016:

  • 80 percent of participating hospitals were designated as Baby-Friendly
  • Best Fed Beginnings nearly doubled the number of Baby-Friendly designated hospitals in the U.S.
  • Exclusive breastfeeding rates increased 22% in participating hospitals
  • 218,000 more infants delivered each year at Baby-Friendly designated hospitals.

“The results of this initiative are encouraging as more and more hospital strive to achieve Baby-Friendly status,” said Lori Feldman-Winter, MD, MPH, head of the Division of Adolescent Medicine at Cooper University, and professor of pediatrics at Cooper Medical School of Rowan University, who served as national faculty chair for the initiative.

“Best Fed Beginnings became a catalyst on the national level for creating hospital environments that support breastfeeding,” says Jennifer Ustianov, MS, BSN, RN, IBCLC, a senior director and perinatal lead at NICHQ. “We’ve now been able to spread the evidence-based methods and strategies in other state-based initiatives to get mothers and babies off to a healthy start.”

The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding.

The initiative was started in response to a low number of Baby-Friendly – designated hospitals in the United States.  The Centers for Disease Control and Prevention funded NICHQ to conduct a national quality improvement initiative – Best Fed Beginnings — between 2011 and 2015. During this intervention period, data and outcomes measures were collected from the participating organizations and in-person, and web-based learning sessions and resources were made available.

By April 2016, a total of 72 (80 percent) of the participating hospitals received the Baby-Friendly designation, nearly doubling the number of designated hospitals in the United States. Participation in the Best Fed Beginnings initiative had significantly high correlation with designation compared with hospital applicants not in the program. In addition, overall breastfeeding increased from 79 percent to 83 percent at those institutions, and exclusive breastfeeding increased from 39 percent  to 61 percent.

“Improving exclusive breastfeeding rates is no easy feat and something these hospitals should be very proud of,” says NICHQ CEO Scott D. Berns, MD, MPH, FAAP, “The progress made by these hospitals and the approach NICHQ used to support them can be viewed as models for other initiatives and facilities to create sustainable change and better support patients and families.”

More about the Best Fed Beginnings initiative can be found on the NICHQ website at


Wendy A. Marano
Public Relations Manager, Cooper University Health Care

Cindy Hutter
Director of Marketing, Communications, NICHQ

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