Regulatory Monitoring of Feeding During the Birth Hospitalization

Breastfeeding improves infant health by reducing the risk of gastroenteritis, lower respiratory tract infection, sudden infant death syndrome, and many other diseases of infancy.¹ Increased awareness of the many benefits of breastfeeding has led public health organizations, including the Centers for Disease Control and Prevention,² the World Health Organization,³ and the American Academy of Pediatrics,⁴ to issue guidelines that support exclusive breastfeeding through 6 months of age. Over the past 2 decades, US rates of any breastfeeding have risen substantially, but rates of exclusive breastfeeding have risen much less.⁵ “Common-sense” approaches to increasing rates of exclusive breastfeeding are sometimes not effective; 2 recent well-designed randomized trials of intensive breastfeeding support revealed no sustained effect on rates of exclusive breastfeeding.^6,7

A recent national policy change regarding breastfeeding was designed to promote exclusive breastfeeding but could possibly have unintended negative consequences on breastfeeding rates and infant health. In April 2010, the Joint Commission added measurement of exclusive breastfeeding during the birth hospitalization to their list …

Address correspondence to Valerie J. Flaherman, MD, MPH, Department of Pediatrics, University of California, 3333 California St, Box 0503, San Francisco, CA 94143-0503. E-mail: flahermanv{at}peds.ucsf.edu