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MICH-21.4 Data Details

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MICH-21.4 Increase the proportion of infants who are breastfed exclusively through 3 months

About the Data: National

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent
Baseline (Year): 
33.6 (2006)
Target: 
46.2
Target-Setting Method: 
Projection/trend analysis
Target-Setting Method Justification: 
The trend for the proportion of infants’ exclusively breastfeeding through 3 months of age for each year of births from 2003 through 2006 predicts an increase of 1.26 percentage points per year. The proposed target of 46.2 percent is reasonable given this trend.
Numerator: 

Number of caregivers of children born in a cohort year who indicate their child was exclusively breastfed (given nothing but breast milk) through 3 months of age

Denominator: 

Number of children aged 19 to 35 months born in the same cohort year

Comparable Healthy People 2010 Objective: 
Retained from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2007 through 2009 National Immunization Surveys:

    [NUMERATOR:]

    Exclusively through 3 months

    Was the child ever breastfed or fed breast milk?

    1. Yes
    2. No

    How old was [child's name] when [child's name] completely stopped breastfeeding or being fed breast milk?

    1. ≥3 months
    2. Still breastfeeding

    How old was [child's name] when (he/she) was first fed formula?

    1. ≥3 months
    2. Never fed formula

    This next question is about the first thing that [child] was given other than breast milk or formula. Please include juice, cow's milk, sugar water, baby food, or anything else that [child] may have been given, even water.

    How old was [child's name] when (he/she) was first fed anything other than breast milk or formula?

    1. ≥3 months
    2. Never given anything but breast milk
Data Collection Frequency: 
Annual
Methodology Notes: 

    Infants are considered to have been breastfed exclusively through 3 months if the responses to questions about age when first fed formula AND age when first fed something other than breast milk or formula both indicate that the child was ≥3 months when either occurred OR that the child has never had formula nor anything but breast milk.

    Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

About the Data: State

Description of the data source, numerator, denominator, survey questions, and other relevant details about the state-level data.

Data Source: 
National Immunization Survey (NIS); Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases and National Center for Health Statistics (CDC/NCIRD and CDC/NCHS)
Measure: 
percent
Numerator: 

Number of caregivers of children born in a cohort year who indicate their child was exclusively breastfed (given nothing but breast milk) through 3 months of age

Denominator: 

Number of children aged 19 to 35 months born in the same cohort year

Questions Used to Obtain the State Data: 

      From the 2007 through 2009 National Immunization Surveys:

      [NUMERATOR:]

      Exclusively through 3 months

      Was the child ever breastfed or fed breast milk?

      1. Yes
      2. No

      How old was [child's name] when [child's name] completely stopped breastfeeding or being fed breast milk?

      1. ≥3 months
      2. Still breastfeeding

      How old was [child's name] when (he/she) was first fed formula?

      1. ≥3 months
      2. Never fed formula

      This next question is about the first thing that [child] was given other than breast milk or formula. Please include juice, cow's milk, sugar water, baby food, or anything else that [child] may have been given, even water.

      How old was [child's name] when (he/she) was first fed anything other than breast milk or formula?

      1. ≥3 months
      2. Never given anything but breast milk
Data Collection Frequency: 
Annual
Methodology Notes: 

      Infants are considered to have been breastfed exclusively through 3 months if the responses to questions about age when first fed formula AND age when first fed something other than breast milk or formula both indicate that the child was ≥3 months when either occurred OR that the child has never had formula nor anything but breast milk.

      Using a computer-generated list, the National Immunization Survey (NIS) identifies households across the United States with children aged 19–35 months and interviews the person who is most knowledgeable about the child’s immunization status (“caregiver”). Survey years are combined to calculate breastfeeding statistics by year of child’s birth (cohort) instead of the year in which the participant was surveyed. To calculate breastfeeding indicators by year of child birth, data are combined across all relevant survey years. Because children are 19—35 months of age at the time of the parent interview, each survey year represents children born over three years. For example, breastfeeding data for children in the 2006 birth cohort are obtained from NIS 2007, 2008, and 2009.

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2012, the word 'breastfeed' was changed to 'breastfed' to reflect the data collected in the survey. Specifically, the NIS data relate to infants who are breastfed, not mothers who breastfeed.

References

Additional resources about the objective

  1. CDC. NIS survey methods.
  2. CDC. Provisional exclusive breastfeeding rates by socio-demographic factors, among children born in 2009.
  3. Smith PJ, Zhao Z, Wolter KM, Singleton JA, Nuorti JP. Age-period-cohort analyses of public health data collected from independent serial cross-sectional complex probability sample surveys. Seattle, WA: Joint Statistical Meeting; 2006.