Study Finds BFHI Practices Mitigate Racial and Ethnic Disparities in Breastfeeding Success

In the United States today, the likelihood of a mother receiving the support she needs to meet her breastfeeding goals is heavily influenced by race and ethnicity—with Black and Hispanic mothers about 40% less likely than White mothers to breastfeed for as long as they intend (Hamner et al., 2021).

Racial and ethnic disparities in breastfeeding don’t just affect individual families—they have long-term consequences for public health and the economy. A 2024 scoping review by Briana Jegier and colleagues found that suboptimal breastfeeding results in annual economic losses exceeding $100 billion in the United States alone—costs largely driven by preventable medical expenses and long-term impacts such as premature death and reduced cognitive development.

Now, a study by Tucker et al. published last month in the Journal of Human Lactation provides some of the strongest evidence to date that implementation of Baby-Friendly Hospital Initiative (BFHI) practices decrease racial and ethnic disparities in breastfeeding success.

The study used a population-based, nationally representative sample of over 60,000 mothers across the US who initiated breastfeeding with healthy, term newborns to investigate the association between race and ethnicity, the receipt of BFHI key clinical practices, and breastfeeding outcomes. The aim of the study was to identify the extent to which BFHI practices implemented during the birth hospitalization influenced breastfeeding success by race and ethnicity. 

Key Findings

• Receipt of BFHI key clinical practices was strongly associated with higher rates of breastfeeding to ≥ 10 weeks across all racial and ethnic groups. The more BFHI practices the mother received, the higher were the odds of breastfeeding to 10 weeks.  
• Among those who received 100% of key clinical practices (designated by the authors as “ideal breastfeeding care”), disparities were eliminated. There were no statistically significant differences in rates of breastfeeding ≥ 10 weeks for Black non-Hispanic, Hispanic English-speaking, or Hispanic Spanish-speaking mothers compared to White non-Hispanic mothers.

“Baby-Friendly practices ensure a high standard of breastfeeding care for all families, regardless of the patient’s race and ethnicity,” said Eileen FitzPatrick, BFUSA’s president and CEO. “We are grateful to the authors for adding to the mounting evidence that implementation of these practices reduces disparities in breastfeeding outcomes.”