Evaluation of supportive breastfeeding hospital practices: a community perspective

study objectives: (1) describe the existing supportive hospital breastfeeding practices in a major urban region and (2) determine if supportive hospital breastfeeding practices are influenced by hospital characteristics. methods: a cross-sectional telephone survey of all hospitals with maternity services (n = 21) in maricopa county, arizona (usa), was conducted between july 2009 and march 2010. this major urban county, which includes phoenix, is the fourth largest city in the usa. supportive breastfeeding practices were 12 maternity care practices consistent with who baby friendly hospital initiative ten steps. hospital characteristics measured were professional breastfeeding services available, institutional ownership, number of births per year, births paid for by public funds, and the level of care provided. descriptive and inferential statistics were conducted. results: the total number of supportive practices ranged from 5 to 10 (m = 7.52; sd = 1.53). two practices were uniformly implemented; the remainder varied from low (> 25%) to moderate (50-75%) levels of implementation. 86% of hospitals had widespread use of supplements and provided gift bags containing formula. the number of board certified lactation consultants (ibclcs) employed by a hospital was the only variable predicting higher levels of supportive practices. facility ownership status was significantly correlated with the number of ibclcs. discussion: the differences in supportive hospital practices among hospitals suggest the effectiveness of ibclcs in changing practice; however, additional research is needed to further explore this thesis. findings of this study, while unique to the community studied, were consistent with a number of findings reported by researchers around the globe.