August 2026 | Enterprise evidence brief
National Breastfeeding Month 2026: Build a Reliable Path from Awareness to Action
For healthcare executives, the observance is a practical test of whether maternity care, lactation support, language access, discharge, community partnership, and measurement function as one reliable system.
The observance name, timing, and 2026 theme were verified with the U.S. Breastfeeding Committee. The analysis below is written for organizational leadership and does not replace individualized clinical care, current professional guidance, or family choice.
Leadership mandate
Treat breastfeeding support as an enterprise reliability question
National Breastfeeding Month can easily become a communications exercise: a social post, a hallway display, a proclamation, and a list of resources. Those activities may increase visibility, but they do not show whether a family can obtain timely, respectful help. The stronger executive question is operational: can the organization reliably translate a family’s goals into coordinated support before birth, during the birth stay, at discharge, and after the family returns home?
That question belongs at the executive table because the answer depends on more than the knowledge of one nurse, physician, midwife, or lactation professional. It depends on staffing, competencies, workflow design, language services, scheduling, supplies, referral agreements, documentation, digital access, benefits, community capacity, and governance. A family may encounter excellent care at one point and still lose support at the next shift, the next setting, or the next unanswered call. The gap is often not a lack of goodwill. It is a system that has not made ownership, escalation, and closure visible.
The 2026 theme, “RISE: Resilience, Interdependence, Self-Determination, Empowerment,” offers a useful management lens. Resilience is not a request that families endure fragmented systems. It is the capacity of the organization to detect strain and recover. Interdependence means that maternity units, neonatal intensive care units, ambulatory practices, pediatric services, lactation teams, interpreters, employers, payers, WIC agencies, and community organizations recognize that their work is connected. Self-determination requires unbiased information and respect for informed feeding decisions. Empowerment becomes practical when families can reach skilled help, understand the next step, and influence how services are designed.
The executive objective should therefore be modest enough to govern and important enough to matter: strengthen one end-to-end support pathway, measure whether it works across groups and operating periods, and keep unresolved barriers visible until an accountable owner closes them. This approach does not reduce the observance to a narrow clinical metric. It connects clinical quality, patient experience, health equity, workforce capability, community partnership, and data stewardship.
Executive question
If a family asks for help at 7 p.m. on a weekend, in a preferred language, after a cesarean birth or neonatal admission, can the organization name the receiving professional, the response route, the backup plan, and the signal that confirms the connection occurred?
What the evidence changes
Implementation matters more than the label
The recent peer-reviewed literature supports a consistent conclusion: breastfeeding-supportive hospital practices can improve initiation and exclusivity, but outcomes depend on implementation quality, context, continuity, and equity. A 2025 systematic review and meta-analysis of 30 studies reported that exposure to the Baby-Friendly Hospital Initiative was associated with earlier initiation and higher exclusive breastfeeding at later time points. The authors also reported substantial statistical heterogeneity, including an I² of 97.1% for early initiation and 82.8% for exclusive breastfeeding at six months.7 For executives, that variation is not a reason to ignore the findings. It is a warning against assuming that adoption, designation, or policy language automatically produces the same result everywhere.
Implementation research reinforces the point. A 2025 analysis using the Non-adoption, Abandonment, Spread, Scale-up, and Sustainability framework found that hospitals in Australia and Indonesia faced interacting barriers involving institutional commitment, workforce, national quality structures, and the work required to sustain practices over time.6 A Hong Kong interrupted time-series study found an increase in the average number of Baby-Friendly steps experienced after implementation, from 3.10 to 3.59, with improved duration in the post-implementation cohort.16 Yet an observational difference-in-differences study of 22,543 Maryland WIC dyads did not find an attributable improvement in initiation or breastfeeding at six months after hospital designation; a possible change at three months did not reach conventional statistical significance.17 The evidence is therefore more nuanced than “designation works” or “designation does not work.” The operational question is which practices reach which families, with what fidelity, and what support continues after discharge.
Several recent studies identify actionable hospital practices. In a 2026 Romanian cross-sectional survey of 357 mothers, rooming-in was associated with higher odds of exclusive breastfeeding, while lack of lactation support was associated with lower odds. The study also reported 49.3% exclusive breastfeeding, 35.6% immediate contact, and 10.6% initiation in the first hour within its sample.2 These values should not be treated as a benchmark for another health system because the design was cross-sectional, the sample was self-selected online, and the context was one country. They are useful because they show how a facility can connect practices and outcomes in one analytic frame while clearly stating limitations.
95% CI 1.779–4.401
95% CI 0.302–0.987
| Reported factor | Adjusted odds ratio | 95% confidence interval | Interpretive limit |
|---|---|---|---|
| Rooming-in | 2.798 | 1.779–4.401 | Association in one cross-sectional survey; no causal inference. |
| Lack of lactation support | 0.546 | 0.302–0.987 | Association in one cross-sectional survey; no causal inference. |
Evidence from specific improvement initiatives adds practical detail. A modified Baby-Friendly intervention in neonatal wards increased reported adherence from 40% to 81%; exclusive breastfeeding was 54.6% at discharge and 49.8% 15 days later.10 A 2026 NICU quality-improvement project trained 36 nurses. Knowledge scores did not change significantly, but nurse-assisted breastfeeding attempts increased from zero during the pre-intervention period to 11 over ten days after the intervention.5 These are encouraging process signals, not proof of durable causal effects. The neonatal ward study used a pre-post design with short follow-up, and the NICU project was small, single-site, and short in duration.
A 2026 observational study of 131 scheduled cesarean births in Spain found that an enhanced recovery pathway was associated with higher odds of breastfeeding, with an adjusted odds ratio of 3.79. Early skin-to-skin contact and breastfeeding support were also independently associated with the outcome.4 A Brazilian quality-improvement project involving 4,800 births across 12 private maternity hospitals reported first-hour breastfeeding in 58% of the sample; prenatal guidance, skin-to-skin contact, and having the indicator as a formal improvement target were positively associated with the outcome.15 Both studies are observational. They support testing reliable processes, but they do not justify promising a result to every patient or treating an association as a treatment effect.
Evidence-to-action rule
Adopt practices because the total evidence and professional guidance support them. Govern implementation as a local improvement system. Report local results with denominators, context, uncertainty, and equity review. Never use an observance, a designation, or one favorable study as a substitute for verification.
The maternity-to-community continuum
Make the support pathway visible before a family needs it
Families experience a sequence, not a departmental org chart. Their questions may begin in prenatal care, change during labor or a cesarean birth, intensify when an infant is premature or medically complex, and continue after discharge when office hours, transportation, work, sleep, pain, milk supply concerns, and competing needs shape what is possible. A reliable system anticipates these transitions and gives each handoff an accountable sender, receiver, backup route, and closure signal.
- Prenatal goalsOffer unbiased counseling, record preferences, identify language and access needs.
- Birth plan responseConfirm goals, explain changes, use consent-based skin-to-skin and rooming-in when clinically appropriate.
- Skilled escalationTrigger qualified lactation and clinical support for pain, feeding difficulty, prematurity, or other concerns.
- Discharge handoffSend the plan, unresolved needs, receiving contact, appointment, and backup route.
- Early follow-upConfirm connection, reassess goals and safety, resolve access barriers, and close the loop.
- Community continuityCoordinate pediatric, postpartum, WIC, peer, employer, and community supports chosen by the family.
Design the birth stay around reliability, not memory
Policies should be observable in practice across shifts and units. Leaders can test whether staff know how to support immediate contact, rooming-in, expression, pumping, supplementation when indicated or chosen, safe storage, and escalation. The purpose is not to force a single pathway. It is to make evidence-based options reliably available and to avoid separating a family from support because the right person is unavailable, a consult order stalls, supplies are difficult to locate, or the record does not carry the plan forward.
The first test is variation. Compare weekdays with nights and weekends; vaginal births with scheduled and unplanned cesarean births; well-newborn care with the NICU; English with the most frequently requested languages; and families with and without reliable transportation, internet, paid leave, or established outpatient care. Variation can reveal where a policy depends on individual heroics. It can also show where a clinically appropriate exception is being confused with a preventable operational defect. The review should include clinical leaders so the organization does not reward speed at the expense of safety or informed choice.
The second test is ownership. A referral is not complete when an order is placed or a phone number is printed. It is complete when the receiving service acknowledges the request, the family understands the next step, urgent concerns have a safe return route, and unresolved barriers remain visible. Where external partners cannot share a record, teams can still define consent, the minimum necessary information, a secure transmission method, confirmation, escalation, and aggregate learning.
Equity, language, and trust
Do not call a service available until families can actually use it
Equity is not a demographic footnote to the pathway. It is a test of whether the pathway works under different language, cultural, financial, geographic, employment, disability, and family conditions. A service that exists only during narrow hours, depends on broadband, assumes paid leave, requires repeated travel, or communicates only in English may be technically present and practically unreachable.
Recent qualitative research makes the design problem concrete. Interviews with 21 Spanish-speaking Latina mothers of preterm infants at two level III NICUs identified the importance of language-concordant communication, qualified interpretation, social support, and care that recognizes the complexity of providing milk while an infant is hospitalized.3 A 2025 quality-improvement needs assessment based on 37 interviews with Hispanic birthing parents at one academic center highlighted deep listening, clear communication across nights and shifts, interpretation, and adequate staff and resources.9 These studies are small and context-specific. Their value is not statistical generalization. Their value is surfacing failure modes that leaders can deliberately test in their own systems.
A community needs assessment involving Black immigrants in Iowa used focus groups and surveys to develop a culturally sensitive intervention framework. It pointed to family, community, employment, and cultural factors that shape breastfeeding experiences.8 A qualitative Ohio study of 66 mothers described how stress, discrimination, and structural conditions intersect with breastfeeding duration; the sample included more White participants than Black or Hispanic participants, which limits subgroup interpretation.13 These findings caution leaders against framing continuation as an individual motivation problem. An organization can offer encouragement and still leave the material barriers untouched.
Work policies are part of the care environment. A 2024 survey of 1,861 participants conducted in the context of COVID-19 stay-at-home orders identified work flexibility, time, and access to support as important features of breastfeeding experience.11 Because the study used an online purposive sample and reflected an unusual policy period, executives should not treat its estimates as a forecast. The managerial implication is sound: return-to-work plans, protected time, space, equipment, scheduling, and benefits can reinforce or undermine the support provided by clinicians.
Use a qualitative fishbone before assigning a cause
When support breaks down, teams often reach too quickly for a single explanation: education, staffing, patient preference, or appointment availability. A qualitative fishbone protects against that shortcut. The branches below are unranked prompts drawn from the evidence and common operational dependencies. They are not measured frequencies, and the diagram is not a Pareto chart.
Unranked branches: policy and benefits; staffing and competencies; language and trust; workflow and handoffs; equipment and technology; work and social conditions.
Build safeguards against coercion and stigma
Breastfeeding-supportive care must remain family-centered. Leaders should require language that offers support without presenting a family’s feeding decision as a moral test. Teams should document goals, explain options and tradeoffs, use shared decision-making, and respond safely when the plan changes. Clinical indications, milk availability, medications, pain, trauma, disability, mental well-being, infant condition, adoption, surrogacy, prior experience, and personal preference may all affect the plan. A reliable system supports breastfeeding when desired and also protects safe, respectful care when families use expressed milk, donor milk when available and appropriate, formula, or a combination.
Community representatives should help design the experience, not merely review a finished campaign. Pay people for expertise when possible. Test materials with speakers of the intended language. Confirm that interpretation is qualified and available across operating hours. Review digital content for assumptions about gender, family structure, literacy, devices, and privacy. Stratify access and process measures only when sample size, privacy, and data quality permit responsible interpretation. Small numbers should trigger careful qualitative inquiry, not public ranking.
Human infrastructure
Competency, coverage, and escalation must work together
Education is necessary, but education alone is not an operating model. A 2026 phenomenological study of 30 nursing students in the United Arab Emirates described the value of structured Baby-Friendly training, simulation, and culturally attentive communication.1 The study examined student experience, not patient outcomes, so it should inform curriculum design rather than serve as proof of effectiveness. The NICU quality-improvement project described earlier offers a complementary lesson: training may change observable practice even when a short-term knowledge test does not show a significant change.5
Executives should define a tiered competency model. Every relevant team member needs foundational skills for respectful communication, the approved support pathway, documentation, and escalation. Some roles need additional unit-specific competency, such as supporting milk expression in the NICU or care after cesarean birth. Lactation professionals and other qualified clinicians need protected capacity for complex assessment and treatment. The goal is not to make every employee an expert. It is to ensure that every employee knows the boundary of the role, can perform assigned responsibilities, and can reach the next level of expertise without delay.
Coverage is part of competency. A service staffed only during limited weekday hours may leave the most time-sensitive work to clinicians without immediate access to expertise. Leaders should map demand and response by hour, unit, language, and acuity. If 24-hour on-site coverage is not feasible, the backup may include cross-trained staff, an on-call model, telelactation, standardized escalation criteria, and a safe interim plan. Each option has limits and should be tested. The organization should not advertise availability that the actual staffing model cannot deliver.
Training should be connected to observation. Instead of relying only on completion rates, use structured case review, simulation, direct observation where appropriate, documentation audits, and family feedback. Review whether team members explain choices, obtain consent, recognize when help exceeds their scope, activate interpretation, and close the handoff. When a failure occurs, examine workload, policy, interface design, supplies, and escalation before attributing the problem to individual effort.
Foundational capability
Respectful communication, informed choice, basic support, documentation, language-service activation, and escalation.
Unit-specific capability
Skills matched to maternity, recovery, pediatrics, NICU, ambulatory, emergency, and community-facing workflows.
Advanced capability
Timely access to qualified lactation and clinical expertise for complex assessment, treatment, and follow-up.
Leadership capability
Capacity planning, equitable access review, learning systems, partner governance, and resource decisions.
Digital and community continuity
Use telelactation as an access route, not a substitute for a system
Telelactation can extend reach, reduce travel, and preserve continuity when in-person support is difficult. Qualitative interviews with 20 Latina parents drawn from a randomized trial found telelactation acceptable and highlighted the importance of continuity and care coordination.12 A separate interview study of 20 Black parents also found telelactation acceptable while showing that virtual support alone cannot resolve every barrier to longer-term breastfeeding.14 Both studies involved small, selected samples. They support thoughtful design and further evaluation, not universal claims about effectiveness or preference.
A digital route should begin with choice. Some concerns require hands-on assessment, clinical examination, or urgent care. Some families prefer in-person support, do not have private space, lack reliable broadband, need interpretation, or cannot use the offered platform. Leaders should specify eligibility, scheduling, consent, identity verification, privacy, documentation, language support, technical assistance, escalation, and the transition to in-person care. Offer telephone and in-person alternatives when feasible. Track failed connections as access defects rather than silently classifying them as no-shows.
The community handoff needs the same discipline. WIC, peer counselors, doulas, home-visiting programs, community health workers, pediatric practices, and employer supports may be essential parts of continuity. Their roles, hours, eligibility, and capacity vary. A health system should co-design the referral with the actual partner, confirm what information is needed, define consent, identify urgent return routes, and agree on what closure can be shared. Referral volume alone is not success. The more meaningful signal is whether the family reached a useful service and whether unresolved needs returned to an accountable team.
Operating system
Put family goals at the center of an accountable network
The operating model should make interdependence explicit. An executive sponsor can remove barriers but should not own daily workflow. An operational leader needs authority across the pathway. Clinical governance should define standards and escalation. Maternity and NICU leaders should ensure shift-level reliability. Lactation and language-service leaders should manage expertise and capacity. Ambulatory, pediatric, and community partners should govern the handoff. Data and improvement teams should maintain definitions, learning cycles, and safeguards.
Govern the handoff as shared work
A reliable handoff has six minimum controls: a trigger, a sender, a receiver, required information, an acknowledgment, and a closure or escalation signal. Those controls should be visible in policy, workflow, technology, and training. If one partner cannot exchange protected information, the teams should still agree on a privacy-preserving confirmation process. If capacity is constrained, the pathway should show how requests are prioritized and where families can safely turn instead.
Leaders should create a small cross-setting governance group with decision rights, not a broad committee that can only recommend. Include a patient or community adviser, clinical leaders, nursing, lactation, language services, operations, ambulatory or pediatric care, a community partner, information technology, and improvement support. The group should review the pathway, decide definitions, assign owners, examine variation, and authorize tests. It should not use stories as proof of prevalence or aggregate rates as proof that every experience is acceptable.
The compact should specify what the health system will provide, what partners will provide, what the family can expect, and what remains contingent on clinical assessment or local capacity. That clarity is especially important during an observance, when public messaging may increase demand. Communications teams should verify hours, contact routes, languages, eligibility, and response expectations before publishing. The safest campaign promise is one the operating system can keep.
Decision-grade measurement
Measure availability, connection, experience, and outcomes without overclaiming
A balanced scorecard should distinguish structure, process, experience, and outcome. Structure measures show whether capability exists. Process measures show whether the pathway was delivered. Experience measures show whether families found it respectful and useful. Outcomes show what happened, but they require careful attribution. Leaders should define each metric before reviewing a trend and should avoid importing a target from another setting without understanding its population, data source, and implementation context.
Every rate needs a numerator, denominator, exclusions, data source, owner, and cadence. Every stratified view needs privacy and small-number safeguards. Every survey needs a clear response denominator and a plan for nonresponse. Every time measure needs a start and stop event. Every outcome needs an explicit statement about what the data can and cannot establish. Qualitative feedback should be coded transparently and presented as themes, not converted into pseudo-precise percentages when the sample does not support them.
| Domain | Candidate measure | Minimum definition | Accountable owner | Cadence | Interpretive guardrail |
|---|---|---|---|---|---|
| Availability | Skilled-support coverage | Hours with an approved primary and backup route, divided by required coverage hours. | Clinical operations | Monthly and after staffing change | Availability does not show that families reached or valued the service. |
| Access | Time to accepted support | Time from documented request to acknowledgment by the receiving qualified role. | Lactation service | Weekly | Separate urgent and routine requests; report abandoned and failed contacts. |
| Language | Preferred-language match | Eligible encounters with qualified interpretation or language-concordant care divided by encounters requiring it. | Language access | Monthly | Do not count unqualified family interpretation as equivalent. |
| Hospital practice | Eligible rooming-in or early-contact support | Eligible encounters in which the approved practice occurred, with clinical and preference-based exclusions defined. | Maternity leadership | Monthly | Never penalize a clinically appropriate exception or an informed family decision. |
| Handoff | Verified connection | Consented referrals acknowledged by the receiving service and understood by the family, divided by referrals sent. | Care management | Weekly | Referral placement alone is not a connection. |
| Experience | Respect and usefulness | Family-reported responses using a defined question set, response denominator, and language-access method. | Patient experience | Monthly or quarterly | Review nonresponse and pair scores with narratives. |
| Outcome | Locally selected feeding outcome | Outcome, time point, data source, denominator, exclusions, and follow-up completeness defined in advance. | Clinical quality | Quarterly | Describe association and missingness; do not imply causation from an uncontrolled trend. |
| Learning | Barrier closure | Selected defects with an owner, due date, verified completion, and post-change review divided by defects accepted for action. | Improvement leader | Biweekly | Counts reflect the review process, not the prevalence of all barriers. |
Pair local data with direct observation
Dashboards can conceal workflow. Executive rounding should follow a request from entry through closure. Ask the family-facing team what happens when the standard route fails. Observe where a status disappears, which information is re-entered, what is delayed outside business hours, and who carries the workaround. Include community partners in the review because a health system can report a completed referral that creates unmanageable work elsewhere.
Use statistical methods that match the data and decision. A run chart may be appropriate for repeated local process measures. A control chart requires stable definitions and adequate data. A forest plot should compare compatible effect estimates and show confidence intervals. A Pareto chart requires real category counts from a defined period. A histogram requires continuous numeric observations and transparent bins. If those conditions are not met, a table or qualitative diagram is more honest and more useful.
How the evidence should influence executive decisions
| Evidence type | What it contributes | What it cannot establish alone | Leadership use |
|---|---|---|---|
| Systematic review and meta-analysis | Direction and magnitude across multiple studies, with heterogeneity. | Uniform effect in every hospital or population. | Select evidence-supported practices and plan for local implementation variation.7 |
| Observational studies | Associations between practices, context, and outcomes. | Causal effect without stronger design and control. | Prioritize measures and test pathways while stating limitations.2, 4, 15, 17 |
| Quality-improvement studies | Feasibility, workflow change, and local process signals. | Generalizability or durability without replication and follow-up. | Design small tests and define sustainment review.5, 9, 10 |
| Qualitative and needs-assessment studies | Experience, mechanisms, barriers, and design requirements. | Population prevalence or ranked frequency without appropriate sampling. | Co-design services and test local failure modes.3, 8, 12, 13, 14 |
Public communication
Promise only what the operating system can deliver
Observance communication should help people reach real services. Before publishing, communications leaders should verify the contact route, operating hours, languages, eligibility, cost information where applicable, privacy notice, expected response, and urgent-care instructions. A page should distinguish educational information from individualized medical advice and should not imply that every service is available at every location or time.
Use respectful language that recognizes breastfeeding, human milk, formula, and combination feeding without shame. Do not use a family story, image, or quote without documented rights and consent. Avoid unsupported superlatives and prevalence claims. If reporting organizational outcomes, publish the measurement period, denominator, source, limitations, and whether the number is audited. If a result is stratified, protect privacy and avoid inviting comparison when sample sizes are unstable.
The campaign should also provide a feedback route. Families and community partners need a way to report that a referral did not connect, interpretation was unavailable, instructions conflicted, or the experience felt coercive or dismissive. Route that feedback to an owner who can respond and improve the system. Closing the feedback loop is a better expression of empowerment than a one-way awareness message.
Internal communication is equally important. Frontline teams should know what the public campaign says, what demand it may create, who receives requests, and how to escalate. Give supervisors a short briefing, not a long document alone. Test the contact path from a mobile phone. Confirm that after-hours instructions match reality. Ask a community partner to review the message for accuracy before launch.
90-day executive agenda
Use the observance to close one visible reliability gap
A 90-day agenda should not attempt to redesign every maternal and infant service. It should select one pathway with executive importance, involve the people who use and operate it, and produce a verified improvement. The phases below are a management framework, not a clinical timeline. Adjust scope and pace to risk, governance, workforce agreements, partner capacity, and required review.
Days 1–30: listen, define, and map
- Name an executive sponsor, an operational owner, a clinical lead, and a community or patient adviser.
- Select one pathway, population, setting, and failure mode. State what is outside scope.
- Observe the current pathway across at least two operating periods and include an after-hours test.
- Interview families, frontline teams, language services, lactation professionals, and receiving partners.
- Document the trigger, sender, receiver, required information, acknowledgment, escalation, and closure signal.
- Define a small scorecard with denominators, exclusions, data sources, cadence, owners, and privacy safeguards.
Days 31–60: co-design, simulate, and pilot
- Co-design the revised workflow with families and every sending and receiving role.
- Write the service promise in plain language and verify hours, languages, capacity, and backup routes.
- Simulate a high-friction scenario, such as a weekend discharge with language, transportation, work, or NICU complexity.
- Pilot at one site or unit with clear stop rules and real-time clinical escalation.
- Review failed contacts, exceptions, staff workload, family feedback, and unintended effects.
- Correct technology, policy, staffing, supply, and partner barriers before broader implementation.
Days 61–90: implement, verify, and govern
- Expand only after the pilot meets defined readiness criteria.
- Monitor access, handoff acknowledgment, experience, and one locally selected outcome.
- Review variation by operating period and population when data quality and privacy allow.
- Hold a learning review for unresolved cases and assign corrective actions with due dates.
- Report what changed, what did not, what remains uncertain, and what resources are required.
- Decide whether to sustain, adapt, expand, or stop the intervention based on evidence and experience.
The August executive commitment
By the end of National Breastfeeding Month, leaders should be able to name one pathway owner, one verified access gap, one tested correction, one community or patient partner, one balanced measure set, and one date for reviewing whether the change lasted.
Leadership close
Make support dependable after August ends
National Breastfeeding Month is most valuable when awareness reveals the system behind the message. The evidence supports breastfeeding-supportive hospital practices, skilled assistance, language access, cultural responsiveness, and continuity. It also shows why leaders should be cautious: study designs and contexts vary, implementation is uneven, and a designation alone is not a guarantee.
The executive task is to build a pathway that respects choice and works across time, settings, languages, and family circumstances. That requires clear ownership, competent teams, practical access, community partnership, honest measurement, and the discipline to keep exceptions visible. A campaign can begin the conversation. A governed operating system is what earns trust.
Scholarly foundation
Peer-reviewed references
References are ordered newest first. Each source was individually reviewed for peer-review status, applicability, and limitations.
- Abuhammad S, Alhemedi A, Ali AM, et al. Emirati nursing students’ experiences and perspectives on Baby-Friendly Hospital Initiative training: a phenomenological study. SAGE Open Nursing. 2026;12. doi:10.1177/23779608261479698
- Constantin AT, Roșca I, Năstase L, et al. Association of hospital practices and early postnatal support with breastfeeding outcomes in premature and term infants. Children. 2026;13(5):642. doi:10.3390/children13050642
- Cordova-Ramos EG, Colvin BN, Witt RE, et al. Factors influencing mothers’ own milk provision among Spanish-speaking Latina mothers of preterm infants. Journal of Human Lactation. 2026;42(2):396–405. doi:10.1177/08903344261427994
- Moreno-Vega S, Vilches JC, García-Pedrajas F, Morales-Gil IM, Rengel-Díaz C. Breastfeeding outcomes after scheduled cesarean section under an ERAS pathway: an analytical observational study. Nursing Reports. 2026;16(4):134. doi:10.3390/nursrep16040134
- Strickland LL, Young LC, Garfield L. A quality improvement project to increase breastfeeding rates in the NICU. Neonatal Network. 2026;45(2):132–141. doi:10.1891/NN-2025-0054
- Pramono A, Smith J, Desborough J. The Baby Friendly Hospital Initiative and Ten Steps to Successful Breastfeeding programs: applying the NASSS health technology adoption framework to analyze challenges to hospital implementation in Australia and Indonesia. International Breastfeeding Journal. 2025;20(1):1–15. doi:10.1186/s13006-025-00754-0
- Habte MB, Abdulahi M, Plusquin M, Cosemans C. Effectiveness of Baby-Friendly Hospital Initiative on early initiation and exclusive breastfeeding practice: systematic review and meta-analysis. Nutrients. 2025;17(14):2283. doi:10.3390/nu17142283
- Awelewa T, Murra A, Story WT. Developing a framework for culturally sensitive breastfeeding interventions: a community needs assessment of breastfeeding experiences and practices in a Black immigrant community. Nutrients. 2025;17(13):2094. doi:10.3390/nu17132094
- Brown-Johnson CG, Kling SMR, Saliba-Gustafsson EA, et al. Hispanic birthing parents’ experiences with lactation support received in-hospital: a quality improvement needs assessment. Journal of Human Lactation. 2025;41(2):207–219. doi:10.1177/08903344251321777
- Rossetto EG, Monteiro ATA, Souza SNDH, et al. Implementation of the modified Baby Friendly Hospital Initiative for neonatal wards. Acta Paulista de Enfermagem. 2025;38(1):1–12. doi:10.37689/acta-ape/2025AO002415i
- Pritz H, Henkes Z, Graham VM, Romo-Palafox MJ. Breastfeeding during COVID-19 stay-at-home orders: implications for future maternal work policies and health equity. Maternal and Child Health Journal. 2024;28(11):1961–1973. doi:10.1007/s10995-024-03990-8
- Alvarado G, Howell K, Waymouth M, et al. Telelactation within the landscape of breastfeeding support: experiences of Latina parents. Journal of Human Lactation. 2024;40(4):602–612. doi:10.1177/08903344241274760
- Dugat V, Dake JA, Czaja E, Saltzman B, Knippen KL. Do stressful events and racial discrimination explain racial gaps in exclusive breastfeeding duration? A qualitative interview study with Black, Hispanic, and White mothers living in Ohio. Journal of Racial and Ethnic Health Disparities. 2024;11(5):2883–2897. doi:10.1007/s40615-023-01748-6
- Howell K, Alvarado G, Waymouth M, Demirci J, Rogers R, Ray K, Uscher-Pines L. Acceptability of telelactation services for breastfeeding support among Black parents: semistructured interview study. Journal of Medical Internet Research. 2023;25:e50191. doi:10.2196/50191
- Alves RV, de Oliveira MIC, Domingues RMSM, Pereira APE, Leal MC. Breastfeeding in the first hour of life in Brazilian private hospitals participating in a quality-of-care improvement project. Reproductive Health. 2023;20(2):1–10. doi:10.1186/s12978-022-01538-z
- Shing JSY, Lok KYW, Fong DYT, et al. The influence of the Baby-Friendly Hospital Initiative and maternity care practices on breastfeeding outcomes. Journal of Human Lactation. 2022;38(4):700–710. doi:10.1177/08903344221086975
- Gross SM, Orta-Aleman D, Resnik AK, et al. Baby Friendly Hospital designation and breastfeeding outcomes among Maryland WIC participants. Maternal and Child Health Journal. 2022;26(5):1153–1159. doi:10.1007/s10995-022-03410-9