356 - CHAMPS National – A CDC funded initiative to increase breastfeeding practices and best practices in 100 US hospitals

Publication Number: 3343.356

Laura Burnham, The Center for Health Equity, Education, & Research, Boston, MA, United States; Mariah Banks, Center for Health Equity, Education, & Research at Boston Medical Center, Boston, MA, United States; Olivia Choi, Center for Health Equity, Education, & Research at Boston Medical Center, Hopkinton, MA, United States; Gianna Hamann, Center for Health Equity, Education, and Research and Boston Medical Center, Boston, MA, United States; Kathryn Pollack-Hinds, Center for Health Equity, Education, and Research, Brooklyn, NY, United States; Madeline Caughron, Center for Health Equity, Education, & Research (CHEER), Springfield, MO, United States; Trendle Samuel, The Center for Health Equity, Education, & Research, Northport, AL, United States; Rebecca Knapp, Boston Medical Center, Princeton, MA, United States; Anne Merewood, Boston University School of Medicine, Boston, MA, United States

Background: CHAMPS National launched in September 2023 as a Cooperative Agreement between the Center for Health Equity, Education, & Research at Boston Medical Center and the Centers for Disease Control and Prevention.

Objective: To increase exclusive breastfeeding rates in 100 US and territorial hospitals, particularly among vulnerable populations, and to increase adherence to the Ten Steps to Successful Breastfeeding.

Design/Methods: CHAMPS National employed a targeted recruitment process focusing on hospitals serving vulnerable families, with low breastfeeding rates, and an interest in implementing the Ten Steps to Successful Breastfeeding. Enrolled hospitals receive coaching, Quality Improvement training and support; breastfeeding-related training, site visits, and data collection help, with an emphasis on safety, equity, and quality improvement. A series of 15 training modules for clinicians and community members, created specifically for the program, offer continuing education credits and can be uploaded to hospitals' training platforms. Hospitals submit data each month on breastfeeding, skin-to-skin, and rooming-in, by race. CHAMPS included community groups such as WIC, doula organizations, and community prenatal clinics in the approach and training to ensure local participation.

Results: CHAMPS National enrolled 100 hospitals across the US and territories, accounting for 202,367 births (5% of all births nationally). At enrollment, over 50% of hospitals did not track skin-to-skin rates, 75% did not track rooming-in, and 37% did not track breastfeeding initiation. Two years into the program, 93 sites are submitting data regularly. From January 2024 through August 2025, average breastfeeding initiation rates across the program increased from 76 to 81%, and exclusive breastfeeding rates from 34 to 39%. Average rates of skin-to-skin care after vaginal birth rose from 43% to 65%; skin-to-skin care post-cesarean rates rose from 29% to 42%, and rooming in rates increased from 38% to 47%. At enrollment, 12% of hospitals reported that their nursing staff had no previous breastfeeding training, and 64% said their providers had no previous training. Sites are rolling out training, with 69 hospitals submitting data on staff training. CHAMPS has completed 88 hospital site visits to date.

Conclusion(s): At 2 years into this 3-year project, we are already observing improvements in practices and breastfeeding outcomes. We anticipate that rates of exclusive breastfeeding, skin-to-skin care, and rooming-in will continue to improve over time.

PAS CHAMPS National Breastfeeding Rates


PAS CHAMPS National Skin-to-Skin Rates


PAS CHAMPS National Rooming-in Rates