
Evidence Tools
Breastfeeding
Introduction
This toolkit summarizes content from the Breastfeeding Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.
From the MCH Block Grant Guidance. The American Academy of Pediatrics (AAP) recommends all infants (including premature and sick newborns) exclusively breastfeed for about six months, followed by continued breastfeeding as complementary foods are introduced for 2 years or longer. However, significant differences in breastfeeding initiation and duration persist by socioeconomic status and race/ethnicity. Breastfeeding supports optimal growth and development, strengthens the immune system, reduces respiratory infections, gastrointestinal illness, and SIDS, and promotes neurodevelopment. Breastfed children may also be less likely to develop diabetes, childhood obesity, and asthma. Maternal benefits include reduced postpartum blood loss due to oxytocin release and possible protective effects against breast and ovarian cancer, diabetes, hypertension, and heart disease.
Goal. To increase the percent of infants who are breastfed and who are breastfed exclusively for six months.
Note. Access other related measures in this Population Domain through the Toolkits page.
Detail Sheet: Start with the MCH Block Grant Guidance
GOAL: To increase the percent of infants who are breastfed and who are breastfed exclusively for six months.
DEFINITION:
Numerators:
A) Number of infants for whom breastfeeding was initiated by hospital discharge
B) Number of children, ages 6 months through 2 years, who are reported by a parent to have been
breastfed or fed breast milk exclusively for 6 months
Denominators:
A) Number of live births, excluding those transferred to another facility within 24 hours and who died before completion of the report (NVSS)
B) Number of children, ages 6 months through 2 years (NSCH)
Units: 100
Text: Percent
HEALTHY PEOPLE 2030 OBJECTIVE: Related to Maternal, Infant, and Child Health (MICH) Objective 15: Increase the proportion of infants who are breastfed exclusively through 6 months (Baseline: 24.9% of infants born in 2015, Target: 42.4%) Related to MICH Objective 16: Increase the proportion of infants who are breastfed at 1 year (Baseline: 35.9% of infants born in 2015, Target: 54.1%)
DATA SOURCES: National Vital Statistics System (NVSS) for states and territories; National Survey of Children’s Health (NSCH)
MCH POPULATION DOMAIN: Perinatal/Infant Health
MEASURE DOMAIN Health Behavior
1. Accelerate with Evidence—Start with the Science
The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.
Evidence-based/Informed Strategies: MCHbest Database
The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.
Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub
Cutting Edge:
- Workplace Policy (CA; 2020)
Emerging:
- Community Support (KS; 2016)
- Home Visiting and Peer Support (MA; 2019)
- Safety Baby Showers (AR; 2017)
- Web-Based Provider Training (VA; 2009)
- Free Mobile Messaging Service (OK; 2016)
Promising:
- Case Management (MA; 2020)
- Family Center (MD; 2020)
- Health Education (NY; 2019)
- Nurse Home Visits (MA; 2018)
- Pregnancy Education (AZ; 2019)
- Telesimulation™ Education (MI; 2020)
Best:
- Community-Based Doula Program (National; 2015)
- Home Visiting (National; 2011)
- Nurse Home Visiting (NC; 2021)
- Ten Health and Nutrition Standards in Childcare (AZ; 2015)
2. Think Upstream with Planning Tools—Lead with the Need
The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.
Move from Need to Strategy
Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.
Planning Tools: Use these tools to move from data to action
3. Work Together with Implementation Tools—Move from Planning to Practice
The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.
Additional MCH Evidence Center Resources: Access supplemental materials from the literature
- Find field-based resources focused on breastfeeding relevant to Title V programs in the MCH Digital Library.
- Search the Established Evidence database for peer-reviewed research articles related to strategies for breastfeeding.
- Request Technical Assistance from the MCH Evidence Center
- MCH Evidence Center Frameworks and Toolkits:
Implementation Resources: Use these field-generated resources to affect change
- National Action Partnership to Promote Safe Sleep (NAPPSS): An MCHB-funded technical assistance resource center, this project supports breastfeeding and safe sleep.
- Data Resource Center for Child and Adolescent Health (DRC): A project of the Child and Adolescent Health Measurement Initiative, the DRC is a national data resource providing easy access to children’s health data on a variety of important topics, including the health and well-being of children and access to quality care.
Practice. The following tools can be used to translate evidence to action to advance this NPM:
- Public Health Strategies for Breastfeeding (CDC). This website includes tools from state programs to support breastfeeding practices.
- Breastfeeding in the Community: Program Implementation Guide (NACCHO). This document offers guidance and tools to help local health departments and community-based organizations design and implement peer and professional lactation support programs.
- The Continuity of Care in Breastfeeding Support Blueprint (NACCHO). This blueprint, developed with a public health lens, aims to increase local capacity to implement community-driven approaches to support breastfeeding.
Partnership. The following organizations focus efforts on supporting breastfeeding:
- American College of Obstetricians and Gynecologists. Provides breastfeeding support resources for providers and others working in pre and perinatal care settings.
- American Academy of Pediatrics. Has updated its policy statement and technical report on breastfeeding and human milk use.
- La Leche League International. Offers breastfeeding support in over 80 countries.
References
Introductory References: From the MCH Block Grant Guidance
1 Meek JY, Noble L; Section on Breastfeeding. Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics.2022;150(1):e2022057988. doi:10.1542/peds.2022-057988.