The Breastfeeding Initiation rate in Connecticut continues its gradual increase (click on Trend, below the graph), reflecting the improving social climate for breastfeeding moms as the benefits of breastfeeding for both mother and child become more widely understood and accepted.  (Note:  You can also toggle the data labels on and off by clicking on Labels, or simply hover the cursor over the data point to observe its values.)

Maternity practices that better support the establishment of breastfeeding, enhanced training of health care professionals, and consistent messaging and peer support, are all important evidence-based interventions for increasing breastfeeding initiation.

Comparing state and national breastfeeding initiation rates (click on Trend Line Comparison, above the graph), Connecticut rates (in blue) have consistently been above the national rates (in orange), and have improved at a faster - though irregular - pace over much of this period.  (Note:  You can also toggle the data labels on and off by clicking on Labels, below the graph.)  Connecticut has also tracked above the national Healthy People Objectives of 75% (HP2010) and 81.9% (HP2020); see respective Notes below.

The CDC's National Immunization Survey's 2013 birth-year cohort data indicate that, nationwide, women with the following socio-demographic characteristics are less likely to initiatiate breastfeeding:

• by Race/Ethnicity: non-Hispanic black women (66.3%), compared to non-Hispanic white women (84.3%);
• by Maternal Education: less than high school (69.3%), compared to college graduates (92.2%);
• by Maternal Age: 20 to 29 years of age (76.5%), compared to women 30 years of age or older (84.5%);
• by Poverty Income Ratio [1]: less than 100 (72.8%), compared to 600 or greater (91.7%).

[1] Poverty Income Ratio = ratio of self-reported family income to the federal poverty threshold value depending on the number of people in the household.

NOTES:

Data:  Connecticut Breastfeeding Initiation data are current as of September 2018, as reported by the CDC on its Nutrition, Physical Activity, and Obesity:  Data, Trends and Maps webpage:  https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.ExploreByLocation&rdRequestForwarding=Form.  Note: "Ever breastfed" is estimated by the question, "Was [child] ever breastfed or fed breast milk?"

Targets:  State-level targets for Breastfeeding Initiation through 2010 are based on the national breastfeeding objectives presented in Healthy People 2010: http://www.usbreastfeeding.org/p/cm/ld/fid=221 (scroll to bottom of page).  Targets for the current decade were set in the Healthy Connecticut 2020 State Health Improvement Plan (see p. 21):  https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/state_health_planning/SHA-SHIP/hct2020/hct2020statehlthimpv032514pdf.pdf'%20class='no-direct-text-content'?la=en.

National Healthy People Objectves:  HP2020:  MICH-21.1 [Revised].  Increase the proportion of infants who are ever breastfed.  Target:  81.9%.  HP2010:  16-19.a.  Breastfeeding, Ever.  Target:  75%.

Data source:  The National Immunization Survey (NIS) uses random-digit dialing to survey US households with children and teens.  NIS breastfeeding rates for birth years 2000-2008 are based on a landline telephone sampling frame, and for birth years 2009 and beyond, on both a landline and cell phone (dual-frame) sampling frame.  All survey respondents with children aged 19 to 35 months are asked the breastfeeding quastions.  Additional information can be found at https://nccd.cdc.gov/NPAO_DTM/.  These later rates are NOT directly comparable to rates from 2008 and earlier.

Potential Partners

Connecticut Department of Public Health (DPH); Connecticut Department of Labor (CT-DOL); Connecticut Department of Social Services (DSS); Connecticut Department of Mental Health & Addiction Services (DMHAS); Connecticut Department of Children & Families (DCF); State Legislature; professional associations for businesses; community health centers; primary care providers; health professional associations for lactation consultants and nutrition; faith-based organizations; community service providers for family, youth, and child development; food industry; federal and state nutrition programs; other organizations and coalitions that focus on breastfeeding and nutrition for women, infants, and children; schools of public health, allied health, nursing, and medicine; and others.

Additional DPH Partners:

Commission on Human Rights and Opportunities (CHRO); Connecticut Breastfeeding Coalition (CBC) and their Ten-Step Collaborative; Connecticut Perinatal Quality Collaborative (CPQC); UConn Health Center for Public Health and Health Policy; Local CT WIC Programs; and, Federally Qualified Health Centers (FQHCs).

The Centers for Disease Control & Prevention (CDC) has identified six (6) broad areas of intervention to improve breastfeeding rates in the U.S.: 1) maternity care practices; 2) support for breastfeeding in the workplace; 3) peer support; 4) educating mothers; 5) professional support; and, 6) media and social marketing. [1]

Through a five-year CDC grant, the Department of Public Health (DPH) is addressing four (4) of these key areas: 1) Increasing Access to Evidenced-Based Maternity Care Practices; 2) Ensuring Worksite Compliance with State and Federal Lactation Accommodation Laws; and, 3-4) Promoting Peer, and Professional, Support for Breastfeeding. The Connecticut WIC Program, under the auspices of DPH, continues to work in the remaining two (2) intervention areas: educating mothers, and media & social marketing.

The results are beginning to be reflected in the data.

[1] Shealy KR, Li R, Benton-Davis S, Grummer-Strawn LM. The CDC Guide to Breastfeeding Interventions. Atlanta: US Department of Health & Human Services (HHS), Centers for Disease Control and Prevention (CDC), 2005.

Advocacy and Policy:

Ensure access to lactation support, including breast pumps, consistent with the Women's Health Provisions of the Affordable Care Act.

Communications:

Increase employee and employer awareness and understanding of their 'rights and responsibilities’ under State and Federal breastfeeding laws.

Education & Training:

Provide targeted technical assistance and support to breastfeeding friendly work places (schools), hospitals, and medical offices to ensure compliance with State and Federal workplace lactation accommodation laws.

Planning & Development:

Engage and plan with established community support networks to promote health equity in breastfeeding initiation, exclusivity and duration.

Source:  Connecticut Department of Public Health. 2014. Healthy Connecticut 2020. 2: State Health Improvement Plan. Hartford, CT: Connecticut Department of Public Health.