Racial Disparities in Breastfeeding

Dear Editor:

Thank you for your interesting and thought-provoking article on racial disparities in breastfeeding. ¹ Queens Hospital Center is part of the Health and Hospital Corporation and serves a racially and ethnically diverse and economically disadvantaged population. We implemented a multidisciplinary approach to improve initiation, exclusivity, and duration of breastfeeding in our population. We engaged obstetricians, prenatal staff, labor and delivery staff, postpartum staff, nursing, social work, hospital leadership, and ancillary services. Our approach included:

• Developing a comprehensive breastfeeding policy and procedure

• Forming a multidisciplinary breastfeeding team

• Monthly meetings

• Regularly reviewing breastfeeding statistics and modifying policies

• Educating ALL staff (obstetricians, nurses, and pediatricians) regarding breastfeeding

• Development of “breastfeeding champions”

• Collaboration with the Special Supplemental Nutrition Program for Women, Infants, and Children and other community partners

• Breastfeeding education for patients in the antenatal period in a culturally sensitive manner with language-appropriate materials

• Rooming-in as the standard for the postpartum floor

• Breastfeeding as the default feeding order and a requirement to have physician orders for formula

• Elimination of “free formula”

• Engaging family members in the education process

• Establishing ongoing postdischarge support via pediatrics, hospital support groups, and community partners

Our breastfeeding initiation rates in labor and delivery improved from 22% in 2007 to 90% in March 2015. Our “exclusive” breastfeeding rates (by The Joint Commission definition) improved from 12% in 2007 to 67% in March 2015. We were the third hospital in New York City to achieve “Baby Friendly” status in 2014.