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TRT Reviewed Breastfeeding Interventions

Baby-Friendly Hospital Initiative

The Baby-Friendly Hospital Initiative (BFHI) is designed to implement hospital policies and procedures that support optimal breastfeeding practices.   Boston Medical Center (BMC) conducted the Baby-Friendly Hospital Initiative in an academic teaching hospital serving primarily minority, poor, and immigrant families living in inner-city Boston, MA.   The Center TRT review compared study results of breastfeeding initiation rates at BMC before (1995), during (1998), and after the Baby-Friendly policies were implemented (1999). Demographics for women giving birth during these three years were African American 57%, Hispanic 23%, and White 14%, with 6% identifying as 'other' races.

Results of the Baby-Friendly Initiative demonstrated that successful implementation of Baby-Friendly policies is associated with an increase in breastfeeding rates across all ethnic and socioeconomic groups.

BMC culturally adapted and displayed artwork depicting breastfeeding women and translated program materials into the three most common languages among the patient population: English, Spanish, and French Creole.

Connecticut Breastfeeding Initiative

The Connecticut Breastfeeding Initiative's reach to multiple subgroups was comparable to that reported by all hospitals in Connecticut.  The table below shows the statewide proportions on several child/mother health indicators as compared to those for the ten CBI hospitals. Public pay birth (Medicaid-paid delivery) proportions, as an indicator of promoting equitable access to BFHI resources among low-income women, are also included. Of the ten CBI hospitals, seven reach a primarily urban population and three reach a primarily rural population.


% Statewide

(of all births in the State*)

% among CBI hospitals  (n=10)

Medicaid-paid delivery



Birthweight (very Low or low)



Prematurity (



Maternal age



Births by race/ethnicity











*Includes births that occurred at 29 acute care hospitals, one birthing center, and at home.

North Carolina Maternity Center Breastfeeding-Friendly Designation  

The NCMCBF Designation Program reaches pregnant and perinatal women across North Carolina.

Texas Mother-Friendly Worksite Program

Participating worksites in Texas include a mix of small and large employers, with 71% of worksites having 50 or fewer employees and 10% of worksites having from 500 to more than 25,000 employees. Most worksites (84%) are in urban settings (50,000 or more people), with 8% in large rural towns (10,000 to 49,999 people), 5% in small rural towns (2,500 to 9,999 people), and 3% in isolated rural towns (fewer than 2,500 people). Worksites represent the full spectrum of industries from the North American Industry Classification System, with heavy representation from the Social Assistance (44.3%), Public Administration (25.8%) and Health Care (16%) industries. These industries have been targeted for the MFWP because they serve large, diverse populations, including low-income families with young children. Based on review of the U.S. Census Equal Opportunity Employment Tabulation Detailed Census Occupation by Industry, Sex, and Race/Ethnicity for worksites in the United States, participating worksites have diverse employee populations. Based on national averages, 62% of MFWP worksites are from industries that have employee populations that are greater than 66% female; 51% of worksites are from industries that have employee populations that are 10% or more Hispanic; and 87% of worksites are from industries that have employee populations that are more than 15% non-Hispanic Black.