Bits and Pieces: Tracking Breastfeeding Initiation Rates
April 15, 2025
The recommendation
We know what we are suppose to be shooting for - that is, what medical organizations like the WHO, ABM, and AAP recommend in terms of breastfeeding initiation and exclusivity:
Exclusive breastfeeding for 6 months
Followed by continued breastfeeding as complementary foods are introduced
With continuation of breastfeeding for 2 year or longer as mutually desired by mother and infant
How do we know how we are doing?
How do we know how we are doing in terms of breastfeeding in our area, state, country?
How do we know if our work is having an effect?
How do what we need to focus on?
Data
In the United States we have data to follow. Below are the results of the 2024 National Immunization Survey (NIS) for any amount of breastfeeding prior to leaving the maternity hospital. This 2024 report reflects births in 2021. This includes the 50 states and Guam, Puerto Rico and Washington DC. These data are usually collected via a phone survey - see more on the methodology here. NIS link
For those of you in the US, how is your state doing? I live in Massachusetts - for 2021 births, 88.7% of women showed some interest in breastfeeding and gave at least a sip of breastmilk prior to leaving the hospital. MA ranked 11th in the nation and was above the national average of 84.1%. It appears women in our state are interested in breastfeeding! But I have so many questions: - How did the hospitals do to support them? - How many women were able to keep going? (stay tuned) - What do state health departments do with this information? - How do other countries track this?
No data are perfect - below reflects one sip counts while what we would like to know about is exclusivity or at least more breast milk than infant formula. This is also based on recall months later. In addition, in some cases the N (number of people surveyed) may not be as high as one would like. BUT at least it is some data!
Rank - state - initiation of breastfeeding (%)
Oregon 93.7%
Hawaii 93.2
Vermont 92.9
Alaska 92.3
Washington 91.2
Utah 91.1
Maryland 89.8
Wyoming 89.3.
Colorado 89.0
California 88.9
Massachusetts 88.7
South Dakota 88.6
Maine 88.2
New Hampshire 87.9
15T. Georgia 87.8
15T. Minnesota 87.8
17. Montana 87.7
18. Connecticut 87.4
19. Puerto Rico 87.0
20. Kansas 86.4
21. Idaho 86.0
22. New York 85.7
23. Michigan 85.3
24. Illinois 85.2
25. Delaware 84.9
26. Arizona 84.5
27. Nebraska 84.3
28. Virginia 84.1 ———— US National Average 84.1
29T. North Carolina 83.5
29T. North Dakota 83.5
31. Washington DC 83.4
32. Wisconsin 83.3
33. Pennsylvania 83.0
34T. Iowa 82.9
34T. Texas 82.9
36. Ohio 82.7
37T. Guam 81.6
37T. New Jersey 81.6
39. Arkansas 81.2
40. Rhode Island 81.0
41. Missouri 80.7
42. South Carolina 80.7
43. Florida 80.6
44. Indiana 79.5
45. Nevada 79.3
46. New Mexico 78.6
47. Oklahoma 78.0
48. Tennessee 77.7
49. Kentucky 75.4
50. Mississippi 73.4
51. Louisiana 73.3
52. West Virginia 68.7
53. Alabama 68.0
This proves a large amount of women want to breastfeed and it's a tragedy what happens next...