Table 4 Community level healthcare facility breastfeeding interventions among women of color in the U.S.: Maternity ward
| Study/Setting | Study Design/ methods | Study Population | Exposure/Intervention | Outcomes and Results | Grade |
|---|---|---|---|---|---|
|
Merewood et al. [53] Maternity Hospitals |
Design: Prospective N = 33 hospitals Data: 2014–17 hospital data | 4 Southern states; N = 31 hospitals; N = 210–3953 records; 2–85% AA; 0–90% H, 5–81% W | at least 3 BFH steps |
BF initiation and EBF increased. Inequities in BF initiation between AA and W decreased by 9.6% points 14 hospitals received BFH designation. | Low |
|
Ahluwalia et al. [54] PRAMS survey |
Design: Retrospective Data: 2004–2006 Pregnancy Risk Assessment Monitoring System (PRAMS) survey |
N = 49,135 women in 11 states and NY City 56.5% W; 14.4% AA, 23.4% H | Maternity Care Practices (MCPs)a |
BF ≥ 10 weeks associated with: early BF initiation (AA & W); BF on demand (AA & H); only breastmilk in hospital (all). BF < 10 associated with: in-hospital pacifier (AA & W), BF support from hospital staff (AA); gift formula pack (H) | Low |
|
Sebastian et al. [55] PRAMS survey |
Design: Retrospective Data: 2012–2014 New Mexico PRAMS survey | N = 4035 Women who initiated BF; 8.4% Spanish-speaking H; 46% English-speaking H; 13.3% AI; 28.2% W | Supportive vs unsupportive BF MCPs | AI and H less likely to report BF at the hospital and receiving phone number for BF support. English-speaking H least likely to BF, only breast milk, staying in the same room, more likely to receive a gift formula pack. | Low |
|
Nobari et al. [56] WIC survey |
Design: Observational Data: Los Angeles County (LAC) WIC Survey (2008, 2011, 2014) | N = 1661 children ≤2 y old born at LAC hospitals (BFH; BFH in process; not BFH); 82% H | Exposure to any of 3 MCPs: Only breastmilk at hospital; Hospital gave gift formula; provided phone number for BF support. | Designated and in-process BFH associated with EBF at 1 and 3 mo. | Low |
|
Jung et al. [57] WIC survey |
Design: pre/post Observational Data: WIC triennial survey (2008, 2011, 2014, 2017) |
N = 6449 eligible clients. 74% H | Exposure to any of 3 MCPs: Only breastmilk at hospital; Hospital gave gift formula; provided phone number for BF support. | Children born in a BFH (designated or in process) significantly higher in 2017 vs. 2014. Less formula packs in 2017. Any BF & EBF at 1 mo higher in 2017. BF at 6 mo and EBF at 1, 3, and 6 mo associated with only BF at hospital. | Low |
| Linares et al. [58] Medical chart |
Design: Prospective Data: Pregnancy survey, medical charts, 1 mo p.p. | N = 97 H; Central Kentucky |
Skin-to-Skin Contact (SSC) SSC vs. non-SCC | Higher EBF at discharge and at 1-mo p.p.; not associated with EBF 1-mo p.p. | Low |
|
Ekambaram et al. [59] Medical chart |
Design: Pre/post observational Data: medical charts, 1 mo p.p. phone survey | N = 283 pre; N = 272 post; Philadelphia, Pennsylvania; 100% AA | Pacifier policy: not offering pacifier at the clinics and BF education. | Intervention associated with EBF on day of discharge; no differences on EBF at 1 mo p.p. | Very Low |