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How well do hospitals support breastfeeding? Depends which media outlet you read

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breastfeedingThe following is a guest post by Carolina Branson, PhD, an associate editor for HealthNewsReview.org.


The blogosphere and news media are overrun with stories on breastfeeding. Recent topics include: Does breast feeding improve IQ? Breastfeeding increases bonding. Is breastfeeding okay in public? Moms feel shamed by being unable to breastfeed. Clearly it is a loaded topic.

The newest spate of breastfeeding stories relate to the recent Center for Disease Control and Prevention’s (CDC) Vital Signs report which details how well hospitals are doing to encourage women to breastfeed. The news release issued by the CDC highlights the progress that U.S. hospitals have made between 2007 and 2013. Among some of the findings were that 93% of hospital staff provided prenatal breastfeeding education (up from 91 percent in 2007), and 92% taught new mothers breastfeeding techniques (up from 88 percent in 2007). However, the report named areas that could use improvement, including not feeding formula to otherwise healthy infants (only 26% made sure only breast milk was given), and keeping the mother and baby together throughout the hospital stay (only 45% of them did this). In addition, the report notes that in 2013, 54% of hospitals were using the recommended Ten Steps to Successful Breastfeeding program (considered a gold standard in hospital-supported breastfeeding) up from only 29% in 2007.

The news release shows that U.S. hospitals are improving but still lag behind where they should be in supporting new mothers with breastfeeding. So, how did the news media present the story? It depends on which outlet you’re looking at. The coverage from CBS and HealthDay is consistent with the narrative of the CDC release. Their stories discuss that while hospitals are improving, they can still do better. The lead from CBS reads, “More hospitals are supporting new moms who breastfeed, and the shift could make for healthier little ones, but officials said today more progress is needed.”

Similarly, the HealthDay report starts out noting the progress U.S. hospitals have made in supporting breastfeeding, including the increase in the number of hospitals incorporating the Ten Steps program. The second half of the story showcases the need for improvement, however: “But there’s still work to be done, the CDC report added. Nearly 4 million babies are born each year in the United States, but only 14 percent are born in ‘baby-friendly’ hospitals that have successfully implemented the entire Ten Steps program.”

Other outlets covering the story didn’t reflect the release so closely. A story from NPR focused mainly on the negative aspects of the report, almost to the exclusion of the positive findings. The lead reads, “Most hospitals around the country aren’t doing a good job of helping new moms who want to breast-feed, researchers report Tuesday in the journal Morbidity and Mortality Weekly Report.” The story focuses on the areas in which hospitals are falling short, with very little discussion of the improvements hospitals have made.

It’s great to see stories that aren’t afraid to closely examine and/or reject the premise of institutional news releases that typically put a positive spin on study results. And there’s certainly plenty to be critical of here. According to the story, only one-third of hospitals provide breastfeeding support to new mothers after they leave the hospital. As Tara Haelle, a journalist who often blogs about parenting and breastfeeding issues at redwineandapplesauce.com, notes, this is one of the most important ways in which breastfeeding is supported. “All the support in the world at a hospital cannot make up for the lack of support outside a hospital, which will affect breastfeeding exclusivity and duration.” (Disclosure: While Haelle did not cover this story, she does report on health for NPR, MedScape, and HealthDay.)

However, the NPR story seems to get off track in its coverage when it juxtaposes hospitals with birth centers. For example, the story highlights the fact that about 90% of birthing centers provide instructions on how to breastfeed and 65% encourage nursing within the first hour. The implication is that hospitals aren’t doing as well on these measures. But the CDC report cites 64.8% of hospitals helping mothers initiate breastfeeding within the first hour after birth and 92.2% providing instructions on breastfeeding, slightly higher than the 90% figure cited for birthing centers. It’s unclear why the NPR story would contrast birthing centers with hospitals on these two outcomes when their performance is virtually the same. There’s also the matter of the story’s lack of any acknowledgment of the positive aspects of the report. Ultimately, these features left the coverage feeling unbalanced and not fully reflective of the report’s overall conclusions.

The outlet that covered the release with the most nuance was CNN. Their story went beyond the report to detail stories of mothers who had negative experiences with breastfeeding support while in the hospital as well as those who had positive experiences. Most importantly, it also brought up some of the possible unspoken outcomes of the report, such as women being made to feel guilty if they can’t or don’t want to nurse. The story smartly brings in the perspective of Michelle Noehren, founder of CTWorkingMoms, noting: “[Noehren’s] concern with the push for more ‘baby-friendly’ hospitals is that more hospitals will be requiring ‘rooming-in’ and no longer offering nurseries. She said such a move actually hurts those moms who don’t want to ‘room-in’ and who might want to get a few hours rest during their brief hospital stay before they are home and on duty 24/7.” This analysis of the social pressures surrounding breastfeeding policies is an important issue to explore, and one some mothers in these situations will no doubt find refreshing.

Clearly the CDC’s report and related news release were covered in many different ways across the media. From an accurate and balanced summary of the findings in the CBS and HealthDay stories, to a more critical tone from NPR, and finally, to the CNN story, which took the report as an opportunity to delve deeper into what this report might mean for mothers in the real world–both positively and negatively.

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Comments (2)

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Felina Gallagher

October 24, 2015 at 10:14 am

Moms do not rest in hospital settings. These images come from years ago, when babies remained in the nursery and mothers were admitted for days, or a week. Aside from the natural tension/connection/concern a new mother has for her just-born infant…there is no relaxing mode setting in hospitals. Anyone who has spent a night or more, will agree- there are too many peronnnel/vitals-taking interruptions, noisy roommates and visitors and overall noise disruptions (and uncomfortable beds/sheets/pillows/room temperature) for something called REST, to be attained. Better to get some hands on deck back at your home, who stir a nutritious pot of soup for mama, all the while soothing and rocking and checking on your little one- in your own clean, baby-ready, quiet environment (yes, silence cell and landline phones).

EB

November 5, 2015 at 10:48 pm

With all my heart, I believe that breastfeeding is good for both babies and mothers. But we truly don’t have strong and reliable scientific evidence to back up my belief except in poor countries. Other measures likely would be more effective in improving babies’ well-being. What about home visits, for example?