According to recently released data, Alabama improved its mPINC score by 5 points to an all-time high of 72 in 2015. You might wonder what in the world that means, and why it is cause for celebration, so I will gladly explain it! The mPINC survey is conducted by the Center for Disease Control (CDC) each year to assess maternity and infant feeding practices at hospitals and birthing centers across the country. The acronym stands for Maternal Practices in Infant Nutrition and Care.
The mPINC survey questions measure infant feeding care practices, policies, and staffing expectations in place at hospitals that provide maternity services. The survey measures a range of factors affecting breastfeeding. Our 72 puts us well ahead of Mississippi (60), Arkansas (67) and Puerto Rico (69). Nevertheless, we lag behind Utah (75), Louisiana (76), Alaska (82), Washington (83) and Colorado (85) - and most of the country, to be honest. We ranked 47th out of 53 respondants.
Labor and Delivery Care
Some of the really encouraging results include that 76% of our facilities are making sure that mothers and babies have 30 minutes of skin-to-skin contact within 1 hour after a vaginal birth, and 51% are making sure that this happens within 2 hours after a cesarean birth. However, less than half are making sure that mothers have the initial breastfeed within the first hour of life. More disturbing is that only 24% perform routine procedures with baby on mom's abdomen/chest.
Feeding of Breastfed Infants
The really good news here is that 90% of Alabama facilities do not give water or glucose water to breastfed infants. However only 76% make sure that the first feed for infants whose mothers have declared their choice to breastfeed is actually breastmilk. Most disappointing is that only 18% of Alabama facilities would say that formula supplementation of breastfeeding infants is rare.
Breastfeeding Assistance
Here is our only 100% - we as a state are perfect in documenting feeding choice in patient charts. We are also very good about having facility staff provide breastfeeding instruction to parents and teach breastfeeding cues. In 78% of our facilities staff actually directly observe a feed. However, only 32% do not routinely offer pacifiers to breastfed infants. It is worth noting that 97% offer prenatal breastfeeding classes, and 83% have a designated staff member coordinating lactation services.
Contact Between Mother and Infant
A startling 41% of mothers and infants are separated during the transition period immediately following birth. Only 24% of facilities report not separating mothers and infants during the stay (in a normal, healthy situation). And only 8% perform routine infant procedures, assessment and care in the mother's room.
Conclusions
Since the first mPINC survey in 2007, Alabama has improved in many areas. Our overall score has increased by 17 points. While that is exciting, it is not enough. We still have a very long way to go to truly normalize breastfeeding in our state. Sadly, 41% of our institutions still routinely provide discharge packs containing formula samples and coupons. 85% of Alabama hospitals receive free formula. Only a dismal 20% of Alabama hospitals have written breastfeeding policy that incorporates all 10 steps of the Baby Friendly Hospital Initiative. The only Hospital in North Alabama to actively seek this designation is Madison Hospital. Nevertheless, as mothers demand more support for breastfeeding and gravitate toward facilities that support them, we can expect to see our numbers continue to improve! I look forward to seeing the 2016 numbers next year!
These statements are depressing to read, but not surprising. We are only taking baby steps with regards to making breastfeeding mainstream.
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