Baby-Friendly Hospital Initiative and Breastfeeding Outcomes Across Social Determinants of Health in Oklahoma, USA: A Secondary Data Analysis.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Breastfeeding Medicine Pub Date : 2026-10-11 DOI:10.1177/15568253261496653

Ingrid R Wilhelm, Emily J Jones, Mark J Fisher, Julie A Gordon, Anitra C Frederick, Jennifer D Peck

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Abstract

Background: Breastfeeding improves maternal and infant health, reducing risks of cancer, diabetes, cardiovascular disease, and infant mortality. Despite national gains in breastfeeding initiation, disparities persist in exclusivity and duration across social determinants of health (SDOH). The Baby-Friendly Hospital Initiative (BFHI) promotes evidence-based maternity care practices to support breastfeeding, yet its effectiveness across diverse populations remains unclear.

Purpose: This study examined whether BFHI designation is associated with breastfeeding outcomes including initiation, exclusive breastfeeding at 8 weeks, and any breastfeeding at 8 weeks among Oklahoma mothers who delivered between 2016 and 2018, and whether these associations differ across SDOH including race, ethnicity, household income, educational attainment, marital status, maternal age, parity, and geographic location.

Methods: A retrospective secondary analysis of linked Oklahoma Pregnancy Risk Assessment Monitoring System and birth certificate data (2016-2018; N = 4,234) was conducted. Weighted logistic regression estimated associations between BFHI designation and breastfeeding outcomes, stratified by SDOH, and adjusted for demographic and socioeconomic factors.

Results: BFHI designation at birth facility was associated with higher odds of initiation among primiparous mothers (adjusted odds ratio [aOR] = 1.89, 95% confidence interval [CI]: [0.98-3.64]), Native American mothers (aOR = 1.43, 95% CI: [0.95-2.15]), and unmarried mothers (aOR = 1.34, 95% CI: [0.89-2.03]). Among mothers with moderate household income ($24,001-$48,000), BFHI designation was associated with significantly greater odds of exclusive breastfeeding at 8 weeks (aOR = 1.85, 95% CI: [1.19-2.89]); a similar, nonsignificant pattern was observed for any breastfeeding at 8 weeks (aOR = 1.63, 95% CI: [0.99-2.70]).

Conclusions: BFHI demonstrates differential effects across SDOH, benefiting first-time and moderate-income mothers but not Black mothers. Culturally responsive nursing care and tailored interventions are needed to achieve breastfeeding equity.

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来源期刊

Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS

CiteScore

4.20

自引率

11.10%

发文量

130

审稿时长

6-12 weeks

期刊介绍： Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.