{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:51:57Z","timestamp":1777852317239,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T00:00:00Z","timestamp":1726185600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Organizational-level interventions (i.e., Baby-Friendly Hospital Initiative) that support breastfeeding and target breastfeeding initiation are critical to reducing breastfeeding disparities and promoting breastfeeding equity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Aim:<\/jats:title>\n                    <jats:p>To determine the association between delivery in a Baby-Friendly accredited hospital and breastfeeding initiation among United States recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Washington DC, the majority of whom report their race as Black.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>\n                      We conducted a secondary analysis of de-identified program data collected as part of routine WIC visits from the Washington DC WIC program, 2017\u20132020. Women who delivered a firstborn, singleton infant were included (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      \u2009=\u20098,225). Multivariable logistic regression models accounted for social determinants of health and other factors. One set of models included a binary exposure variable (Baby-Friendly accredited vs. non-accredited hospitals), and another set included a categorical exposure variable for hospitals (1) Baby-Friendly accredited, (2) Baby-Friendly activities but not accredited, and (3) neither Baby-Friendly activities nor accredited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Breastfeeding initiation was 57.4% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091988) for women delivering in accredited hospitals versus 55.4% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092540) in non-accredited hospitals and multivariable model results were non-significant (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      \u2009=\u20090.95, 95% CI [0.86, 1.05]). However, more women initiated breastfeeding who delivered in either accredited hospitals (57.4%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091988) or hospitals with Baby-Friendly activities but not accredited (55.9%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092430) compared to those delivering in hospitals with neither (45.3%,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009110), and multivariable models results concurred (Baby-Friendly accredited hospitals\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      \u2009=\u20091.44, 95% CI [1.07, 1.94]; Baby-Friendly activities but not accredited, (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      \u2009=\u20091.55, 95% CI [1.16, 2.09]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Organizational-level interventions that create hospital environments supportive of breastfeeding initiation are important to promote equity in breastfeeding, but underlying social determinants of breastfeeding outcomes must be addressed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344241274306","type":"journal-article","created":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:18:30Z","timestamp":1726273110000},"page":"570-581","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Baby-Friendly Hospitals, Social Determinants of Health, and Disparities in Breastfeeding Initiation in a Low-Income Population, 2017\u20132020"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1660-9681","authenticated-orcid":false,"given":"Rebecca C.","family":"Robert","sequence":"first","affiliation":[{"name":"Conway School of Nursing, The Catholic University of America, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-1575","authenticated-orcid":false,"given":"Amira A.","family":"Roess","sequence":"additional","affiliation":[{"name":"Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Kuehn","sequence":"additional","affiliation":[{"name":"The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swathi","family":"Vinjamuri","sequence":"additional","affiliation":[{"name":"The District of Columbia (DC) Department of Health, DC Women Infant Child (WIC) State Agency, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"crossref","unstructured":"Assibey-Mensah V. 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