The critical insights from the Breastfeeding Report Card help guide efforts from government agencies, non-profit organizations, coalitions, educational institutions, and stakeholders from across the field of public health to design interventions and strengthen systems of support. Given the long-lasting positive health outcomes for children and those who lactate, the far-reaching impact on public health, and the widespread consensus from leading pediatric and medical associations, there is no doubt that our work together to build a landscape of support for breastfeeding families is essential.
The 2022 Breastfeeding Report Card showed a persistence of racial and ethnic disparities, a need for strengthened systems of support for families, and while not statistically significant, a slight decline in any and exclusive breastfeeding rates. We will take a closer look at key findings from this year’s report to help inform our work to improve breastfeeding practices and supports.
Breastfeeding Report Card, 2022
The most recent report card looks at breastfeeding rates among children born in 2019. This data was collected across 2020–2021, and the CDC notes that it may partially reflect breastfeeding duration and exclusivity during the COVID-19 pandemic. In addition to statistics on breastfeeding initiation and duration, this year’s report included data on maternity care practices, workplace policies, and childcare practices.
To assess how maternity care practices are impacting lactation outcomes, the report card includes state scores from the Maternity Practices in Infant Nutrition and Care (mPINC) survey and the portion of births that occurred at Baby-Friendly designated facilities. The 2022 Breastfeeding Report Card also features two new support indicators:
Most Infants Initiate Breastfeeding
The latest data shows that 83.2% of infants initiate breastfeeding with 24.9% of babies exclusively breastfeeding at 6 months of age. When we look at these rates from 2007 to 2022, we see that there is a relatively steady increase in breastfeeding rates across time. However, as depicted in Figure 1, we see a slight decrease in the most recently published report in 2022. This shift is not statistically significant, however the U.S. Breastfeeding Committee and our partners are closely following how this data changes over time.
Racial & Ethnic Disparities Persist
CDC data shows that breastfeeding rates still vary significantly by race and ethnicity. Among children born in 2019, Non-Hispanic White infants were breastfed at higher rates than Non-Hispanic Black infants and Hispanic infants. At six months, more white infants (26.9%) were exclusively breastfed, in comparison to their Black (19.1%) and Hispanic (23.5%) counterparts. Disparities in access to lactation-supportive environments are creating and perpetuating disparities in breastfeeding rates and associated health inequities. The lactation field must prioritize closing these gaps.
Rates Plummet as Babies Grow
This year's report continues to show a significant drop in breastfeeding rates as the child ages. While the majority of infants initiated breastfeeding, by six months of age this number dropped drastically. This discrepancy demonstrates why the strength and accessibility of systems of support at the policy, organizational, and community levels are so critical for improving breastfeeding duration and exclusivity.
Systems of Care for Families Need to be Strengthened
These outcomes highlight the need to continue to strengthen the support landscape so that families can make informed decisions and are set up for success. No baby should ever go hungry, and the policies that shape and influence a family's experience can make a difference in protecting the nutrition security of infants.
Research clearly demonstrates that maternity care practices have a significant and lasting impact on infant feeding outcomes. The report card continues to include mPINC scores, formula supplementation rates, and the percentage of births taking place in Baby-Friendly designated hospitals.
In the absence of a national paid family and medical leave program, many mothers and parents have no choice but to return to work quickly after the birth of their child, often before they have established a strong feeding routine. This year’s report card newly identifies which states have enacted statewide paid family and medical leave (PFML) programs and how many weeks are covered for new parents. Currently, 12 states have passed legislation to create PFML programs. However, four of these were recently passed and have not yet begun paying benefits.
Many families rely on early childcare providers for their infants as caregivers continue to work or go to school. This year's Breastfeeding Report Card includes scores that rate how strongly state early care and education licensing requirements align with the breastfeeding support standard, with nine states receiving the top score and five states not addressing lactation in any way.
Together, these new indicators and the maternity care practices data help paint a clearer picture of the supportive environments that can benefit all families and allow them to provide human milk to their babies.
A Call to Action
The 2022 Breastfeeding Report Card suggests that we can and must do better for our nation's babies. The solutions are clear: we need policy, system, and environmental change to remove the barriers and ensure infants have access to human milk. Human milk feeding is a high-value, low-cost public health intervention that provides a substantial return on investment. Please take action today by urging the President and Vice President to increase funding for breastfeeding in the President's budget request!
10/25/2022 03:12:44 pm
The "inclusive" language is offensive and hides the actual data. Women / MOTHERS are not breastfeeding as long or as exclusively as in prior years. "FAMILIES" do not breastfeed. Only mothers breastfeed with or without the support of their families.
Nikia Sankofa, USBC Executive Director
11/1/2022 12:03:58 pm
The U.S. Breastfeeding Committee is committed to bringing together a diversity of voices and perspectives to advance policy, systems, and environmental changes that build a landscape of support. We are working to do this through an equity lens to ensure that our work actively addresses the persistent disparities that have plagued marginalized and oppressed communities, and as part of that effort are working hard to open the space for considering how gendered language contributes to these disparities.
10/25/2022 03:53:58 pm
There should be TV advertisements promoting the PFML so that more mothers will be aware of it and therefore request this time.
10/26/2022 08:02:29 am
Babies are our future society after the pandemic we owe it to our next world leaders a leg up on life health and support. Studies do show that breast is best ! Let’s give our nations most prized gifts (our children) the best chance !
10/26/2022 10:39:21 am
As an "on the ground" IBCLC in private practice, I am see different factors than those named above as the primary drivers of the decrease in breastfeeding rates. Specifically, I lay the blame on increasing emphasis on sleep training, swaddling and schedules that are being promoted by social media influencers and popular programs such as Moms on Call and Taking Cara Babies. In my 11 years as a lactation consultant, the culture that once dabbled in Babywise is now fully inundated with harmful messages coming primarily from social media that babies should sleep through the night without feeding, rapidly decrease their number of daytime feedings as they get older, and be physically restrained from showing feeding cues (ie swaddling) for the majority of the hours of their day. These are the daily life realities I come up against over and over again that are causing breastfeeding rates to drop. I've been telling my colleagues for the past few years to "mark my words - when the CDC publishes data for these years there will be a significant drop in breastfeeding rates." We are just getting started witnessing this decline, as I expect the next few years of data to be even worse. Until these harmful messages are publicly and consistently confronted the reality won't change. Even changes to maternity leave will not dramatically impact rates, as stay at home moms are embracing these messages that lead to lactation failure just as much as working moms. PLEASE listen to the on ground IBCLCs who are seeing this everyday and widen the scope of focus beyond the political to the social and cultural influences.
11/4/2022 10:19:53 pm
One of the actions for this year for USBC can be to advocate for HHS or CDC to develop a series of PSAs that discuss parenting and babies physiological and psychological needs (almost continuous contact with mother's body and breast during the first months of life -- along with examples of policies and programs that support these such as paid maternal and family leave, Baby and Mother Friendly Hospital care, ECE that is supportive of breastfeeding -- to educate general public on normality of breastfeeding behaviors and how to support them, even in this world where there is much pressure on mothers to go back to work early on. There needs to be massive re-education on these topics and only Federal government has resources and reach to do this. There would definitely be members of Congress that would support increased budget for this.
11/18/2022 09:12:08 am
You talk about improving the disparities in breastfeeding but I want to know how that we can do this!
2/15/2023 01:53:21 am
Thank you for sharing a post, nice to read it, good work keep going
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