CDC National Survey of Maternity Practices in Infant Nutrition and Care (mPINC)–2009

Table 3.1a: Documentation of infant feeding decisions
by facility type, size, NICU level, and region
How often infant feeding decisions are documented in medical records
Rarely Sometimes Often Almost always Not sure N
All 0.2 0.4 1.6 97.7 0.1 2658
Type of facility
Birth center 0.9 0.9 0.0 97.4 0.9 117
Government hospital 0.2 0.6 3.4 95.8 0.0 523
Non-profit hospital 0.2 0.2 1.2 98.3 0.1 1667
Private hospital 0.0 0.9 0.9 98.2 0.0 329
Military hospital 0.0 0.0 4.8 95.2 0.0 21
Teaching hospital
Yes 0.6 0.0 1.1 98.3 0.0 176
No 0.1 0.4 1.7 97.7 0.1 2364
Size of facility
0-249 0.7 0.5 1.7 96.9 0.2 589
250-499 0.0 0.2 1.5 98.2 0.0 455
500-999 0.0 0.0 1.6 98.4 0.0 553
1000-1999 0.0 0.8 1.7 97.3 0.2 526
2000-4999 0.2 0.4 1.3 97.8 0.2 462
5000 or more 0.0 0.0 1.6 98.4 0.0 63
Unknown 0.0 0.0 0.0 100.0 0.0 10
Level of Neonatal Care
Healthy newborn only 0.4 0.6 1.6 97.4 0.1 1082
Level 1 or 2 NICU 0.0 0.3 1.5 98.1 0.1 1021
Level 3 NICU 0.2 0.2 1.8 97.7 0.2 555
Census region
Pacific 0.0 0.8 3.4 95.5 0.3 353
Mountain 0.5 0.9 4.1 94.6 0.0 221
West North Central 0.6 0.6 1.4 97.5 0.0 362
East North Central 0.0 0.0 0.4 99.6 0.0 451
West South Central 0.3 0.6 1.9 96.9 0.3 323
East South Central 0.0 0.0 0.6 99.4 0.0 175
New England 0.0 0.0 0.0 100.0 0.0 134
Middle Atlantic 0.4 0.0 1.2 97.9 0.4 241
South Atlantic 0.0 0.3 1.0 98.7 0.0 398

Table 3.2a: Provision of advice & instructions for breastfeeding patients
by facility type, size, NICU level, and region
How many breastfeeding patients are provided
advice & instructions about breastfeeding
Few Some Many Most Not sure N
All 0.2 1.1 9.5 89.1 0.1 2654
Type of facility
Birth center 0.0 0.8 5.1 94.1 0.0 118
Government hospital 0.0 2.1 13.7 84.2 0.0 519
Non-profit hospital 0.2 0.6 8.6 90.6 0.1 1666
Private hospital 0.3 1.5 9.4 88.4 0.3 329
Military hospital 0.0 9.5 9.5 81.0 0.0 21
Teaching hospital
Yes 0.0 0.0 6.2 93.8 0.0 177
No 0.2 1.2 10.0 88.5 0.1 2358
Size of facility
0-249 0.3 1.9 12.3 85.5 0.0 587
250-499 0.0 0.9 9.5 89.4 0.2 452
500-999 0.0 0.7 10.3 88.8 0.2 554
1000-1999 0.2 0.8 7.6 91.4 0.0 526
2000-4999 0.2 1.3 7.6 90.9 0.0 462
5000 or more 0.0 0.0 9.5 90.5 0.0 63
Unknown 0.0 0.0 0.0 100.0 0.0 10
Level of Neonatal Care
Healthy newborn only 0.2 1.6 10.7 87.5 0.0 1081
Level 1 or 2 NICU 0.0 0.6 9.5 89.7 0.2 1018
Level 3 NICU 0.4 1.1 7.2 91.4 0.0 555
Census region
Pacific 0.0 1.1 9.1 89.8 0.0 352
Mountain 0.0 1.8 14.9 83.3 0.0 222
West North Central 0.0 1.4 10.9 87.7 0.0 358
East North Central 0.0 0.7 7.6 91.5 0.2 448
West South Central 0.3 2.8 11.4 85.5 0.0 325
East South Central 0.0 0.6 10.3 89.1 0.0 175
New England 0.0 0.0 4.5 95.5 0.0 134
Middle Atlantic 0.8 0.0 7.0 92.1 0.0 242
South Atlantic 0.3 0.8 9.3 89.4 0.3 398

Table 3.3a: Education on infant cues to feed
by facility type, size, NICU level, and region
How many patients are taught to recognize & respond
to infant cues rather than feeding on a set schedule
Few Some Many Most Not sure N
All 0.2 2.2 15.4 81.9 0.3 2651
Type of facility
Birth center 0.0 0.8 8.5 90.7 0.0 118
Government hospital 0.4 4.4 20.6 73.8 0.8 519
Non-profit hospital 0.1 1.2 14.7 83.8 0.2 1664
Private hospital 0.3 3.7 13.1 82.3 0.6 328
Military hospital 0.0 4.8 19.0 76.2 0.0 21
Teaching hospital
Yes 0.0 1.7 13.6 84.2 0.6 177
No 0.2 2.3 15.9 81.3 0.3 2355
Size of facility
0-249 0.5 3.6 17.7 77.7 0.5 588
250-499 0.0 1.5 14.8 83.2 0.4 452
500-999 0.0 2.7 17.2 79.7 0.4 553
1000-1999 0.2 1.1 12.0 86.5 0.2 525
2000-4999 0.2 1.5 14.8 83.3 0.2 460
5000 or more 0.0 1.6 15.9 82.5 0.0 63
Unknown 0.0 0.0 20.0 80.0 0.0 10
Level of Neonatal Care
Healthy newborn only 0.3 2.8 16.9 79.5 0.6 1081
Level 1 or 2 NICU 0.1 2.1 14.3 83.4 0.2 1017
Level 3 NICU 0.2 1.1 14.6 83.9 0.2 553
Census region
Pacific 0.3 2.6 15.3 81.8 0.0 352
Mountain 0.5 3.2 18.6 77.8 0.0 221
West North Central 0.0 1.9 20.6 77.2 0.3 359
East North Central 0.0 1.1 13.4 85.3 0.2 448
West South Central 0.6 3.4 17.6 77.8 0.6 324
East South Central 0.0 5.2 14.9 78.2 1.7 174
New England 0.0 0.7 4.5 94.8 0.0 134
Middle Atlantic 0.4 0.8 13.2 85.5 0.0 242
South Atlantic 0.0 1.5 14.9 83.1 0.5 397

Table 3.4a: Education on limitation to time suckling
by facility type, size, NICU level, and region
How often are breastfeeding patients instructed to
limit suckling at the breast to a specific length of time
Rarely Sometimes Often Almost always Not sure N
All 42.5 25.1 15.8 14.9 1.7 2645
Type of facility
Birth center 72.0 13.6 2.5 11.0 0.8 118
Government hospital 33.2 27.2 20.1 18.1 1.4 518
Non-profit hospital 45.7 25.4 14.4 12.5 2.0 1660
Private hospital 31.2 24.2 20.5 23.5 0.6 327
Military hospital 28.6 38.1 23.8 4.8 4.8 21
Teaching hospital
Yes 50.3 27.7 11.9 8.5 1.7 177
No 40.4 25.5 16.8 15.5 1.7 2349
Size of facility
0-249 37.6 24.4 14.7 21.7 1.5 585
250-499 41.2 24.6 18.6 13.7 1.8 451
500-999 42.0 26.1 14.3 16.1 1.4 552
1000-1999 47.0 23.4 17.9 10.3 1.3 525
2000-4999 43.8 27.0 14.4 12.2 2.6 459
5000 or more 49.2 28.6 14.3 6.3 1.6 63
Unknown 70.0 20.0 0.0 10.0 0.0 10
Level of Neonatal Care
Healthy newborn only 40.5 23.8 15.5 18.1 2.0 1078
Level 1 or 2 NICU 41.8 26.3 17.2 13.4 1.3 1015
Level 3 NICU 47.6 25.5 13.8 11.2 1.8 552
Census region
Pacific 55.4 20.7 13.4 8.8 1.7 352
Mountain 33.6 25.9 20.0 16.8 3.6 220
West North Central 33.1 33.1 15.4 16.0 2.5 357
East North Central 49.2 26.6 11.2 11.9 1.1 447
West South Central 29.9 25.6 21.0 22.8 0.6 324
East South Central 32.9 20.8 17.9 26.6 1.7 173
New England 65.4 19.5 9.0 5.3 0.8 133
Middle Atlantic 47.5 24.4 16.9 10.3 0.8 242
South Atlantic 40.6 23.7 17.6 15.9 2.3 397

Table 3.5a: Directly observed breastfeeding assessments
by facility type, size, NICU level, and region
How many breastfeeding patients receive
a directly observed breastfeeding assessment
Few Some Many Most Not sure N
All 0.3 2.6 14.4 82.7 0.1 2654
Type of facility
Birth center 0.0 0.0 1.7 98.3 0.0 118
Government hospital 0.8 3.5 20.5 74.9 0.4 521
Non-profit hospital 0.1 2.2 13.3 84.4 0.0 1664
Private hospital 0.3 3.6 14.3 81.8 0.0 329
Military hospital 0.0 9.5 14.3 76.2 0.0 21
Teaching hospital
Yes 0.0 4.5 16.4 78.0 1.1 177
No 0.3 2.5 14.8 82.3 0.0 2358
Size of facility
0-249 0.7 2.0 14.3 83.0 0.0 589
250-499 0.2 2.0 14.5 83.3 0.0 455
500-999 0.2 3.1 16.3 80.3 0.2 552
1000-1999 0.0 2.7 11.2 86.1 0.0 527
2000-4999 0.2 2.6 15.1 81.9 0.2 458
5000 or more 0.0 6.3 19.0 74.6 0.0 63
Unknown 0.0 0.0 10.0 90.0 0.0 10
Level of Neonatal Care
Healthy newborn only 0.5 2.5 14.1 82.9 0.0 1083
Level 1 or 2 NICU 0.1 2.0 13.9 84.0 0.0 1019
Level 3 NICU 0.2 3.8 15.6 80.1 0.4 552
Census region
Pacific 0.0 1.1 9.7 89.2 0.0 351
Mountain 1.4 1.8 14.1 82.7 0.0 220
West North Central 0.0 2.2 15.5 82.3 0.0 361
East North Central 0.0 2.5 13.8 83.7 0.0 448
West South Central 0.6 4.9 20.9 73.2 0.3 325
East South Central 0.6 1.7 18.9 78.3 0.6 175
New England 0.0 0.7 6.7 92.5 0.0 134
Middle Atlantic 0.0 2.5 15.7 81.8 0.0 242
South Atlantic 0.3 3.8 12.6 83.4 0.0 398

Table 3.6a: Use of a standardized breastfeeding assessment tool by
facility type, size, NICU level, and region
Is breastfeeding assessed using a standardized
or adapted assessment tool
Yes No N
All 60.3 39.7 2634
Type of facility
Birth center 25.2 74.8 115
Government hospital 49.2 50.8 518
Non-profit hospital 66.6 33.4 1652
Private hospital 58.7 41.3 327
Military hospital 52.4 47.6 21
Teaching hospital
Yes 69.1 30.9 175
No 61.4 38.6 2343
Size of facility
0-249 39.6 60.4 586
250-499 54.8 45.2 451
500-999 61.2 38.8 546
1000-1999 70.1 29.9 521
2000-4999 77.9 22.1 457
5000 or more 76.2 23.8 63
Unknown 60.0 40.0 10
Level of Neonatal Care
Healthy newborn only 48.2 51.8 1074
Level 1 or 2 NICU 66.6 33.4 1009
Level 3 NICU 72.2 27.8 551
Census region
Pacific 75.9 24.1 348
Mountain 67.3 32.7 220
West North Central 56.4 43.6 360
East North Central 64.5 35.5 445
West South Central 47.5 52.5 324
East South Central 45.0 55.0 171
New England 68.4 31.6 133
Middle Atlantic 63.6 36.4 239
South Atlantic 53.8 46.2 394

Table 3.7a: Provision of pacifiers
by facility type, size, NICU level, and region
How many breastfed infants are given pacifiers by facility staff
Few Some Many Most Not sure N
All 30.2 28.5 29.3 11.0 1.1 2640
Type of facility
Birth center 93.2 2.5 1.7 1.7 0.8 118
Government hospital 26.6 28.2 32.0 12.5 0.6 518
Non-profit hospital 28.9 30.0 29.7 10.3 1.1 1656
Private hospital 18.1 31.0 33.4 15.6 1.8 326
Military hospital 47.6 23.8 23.8 4.8 0.0 21
Teaching hospital
Yes 39.2 29.5 23.3 8.0 0.0 176
No 26.3 29.7 31.2 11.7 1.2 2345
Size of facility
0-249 39.9 28.3 20.5 9.7 1.5 586
250-499 23.5 30.8 33.5 10.9 1.3 451
500-999 25.0 23.5 36.8 13.8 0.9 549
1000-1999 26.7 30.3 29.0 13.2 0.8 524
2000-4999 31.7 29.5 30.9 7.2 0.7 457
5000 or more 41.3 38.1 11.1 7.9 1.6 63
Unknown 80.0 0.0 10.0 10.0 0.0 10
Level of Neonatal Care
Healthy newborn only 35.4 27.1 26.0 10.0 1.4 1076
Level 1 or 2 NICU 22.9 28.7 34.7 12.8 0.9 1014
Level 3 NICU 33.3 30.7 25.8 9.5 0.7 550
Census region
Pacific 47.3 28.6 18.7 4.5 0.8 353
Mountain 26.5 28.3 32.9 11.0 1.4 219
West North Central 18.5 36.4 32.5 10.4 2.2 357
East North Central 23.8 32.7 32.1 10.8 0.7 446
West South Central 27.6 24.2 28.0 19.6 0.6 322
East South Central 18.4 20.7 40.8 19.5 0.6 174
New England 52.3 25.8 18.2 3.0 0.8 132
Middle Atlantic 35.8 29.6 26.3 7.5 0.8 240
South Atlantic 31.0 23.7 32.5 11.6 1.3 397