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Despite decades of public health campaigns encouraging breastfeeding, significant racial and ethnic disparities remain in who continues to breastfeed in the weeks after birth. A recent study published in the Journal of Human Lactation offers powerful new evidence that hospital practices—especially Baby-Friendly practices—can make a major difference in narrowing this gap.
What Was the Study About?
Researchers from the CDC and Emory University examined data from over 15,000 mothers who had healthy, full-term births and intended to breastfeed. They looked at how many "Baby-Friendly Hospital Initiative" (BFHI) practices these mothers experienced during their hospital stay—and how that affected their breastfeeding continuation at 10 weeks postpartum.
What Is the Baby-Friendly Hospital Initiative?
The Baby-Friendly Hospital Initiative (BFHI) is a global program developed by the World Health Organization (WHO) and UNICEF to encourage hospitals to support breastfeeding through 10 specific clinical steps. These steps include things like:
- Helping mothers initiate breastfeeding within the first hour
- Keeping moms and babies together (rooming-in)
- Avoiding formula unless medically necessary
- Educating parents on infant feeding and ongoing support
What Did the Study Find?
1. More Baby-Friendly Practices = More Breastfeeding Continuation
Mothers who experienced more BFHI practices were significantly more likely to continue breastfeeding at 10 weeks, across all racial and ethnic groups.
2. Racial/Ethnic Disparities Shrink With Full Implementation
When mothers experienced all 7 key BFHI practices measured in the study, the racial and ethnic gap in breastfeeding continuation nearly disappeared.
For example:
- Among those who received all 7 practices, 76–79% of moms across racial and ethnic groups were still breastfeeding at 10 weeks.
- In contrast, among those who received 0–3 practices, continuation rates dropped—and disparities widened.
3. Baby-Friendly Practices Benefit Everyone—But Especially Marginalized Groups
The findings suggest that BFHI practices are a powerful equalizer, especially for Black and Hispanic mothers, who have historically faced lower breastfeeding continuation rates due to systemic barriers.
Click here to read the full article.
Why This Matters
In the U.S., structural inequities—ranging from hospital bias to lack of culturally competent support—have made it harder for many BIPOC families to continue breastfeeding, even when they intend to do so.
This study shows that hospital policies and protocols are not just background details—they are critical interventions that can either reinforce or reduce disparities.
What Can Hospitals and Providers Do?
- Fully implement BFHI practices and aim for Baby-Friendly designation.
- Train staff in culturally competent care and bias awareness.
- Ensure equitable access to lactation support, especially in communities of color.
- Engage families early and provide postpartum follow-up that supports continuation.
Final Thoughts
This research adds to the growing evidence that equitable breastfeeding outcomes start in the hospital. When all mothers are given consistent, evidence-based support, they are more likely to succeed in their feeding goals—regardless of race or ethnicity.
If we want to close the breastfeeding gap, we need to start where the birth experience begins: at the bedside.
Interested in learning more about Baby-Friendly practices or finding support for breastfeeding continuation? Connect with certified lactation consultants or visit Baby-Friendly USA to find a Baby-Friendly hospital near you.
Disclaimer: This blog's content is provided for informational purposes only, and does not intend to substitute professional medical advice, diagnosis, or treatment and you should not rely solely on this information. Always consult a professional in the area for your particular needs and circumstances prior to making any professional, legal, medical and financial or tax-related decisions.
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