mPINC™ Ten Steps Assessment Tool

About the mPINC™ Ten Steps Assessment Tool

This tool helps assess how a hospital implements each of the Ten Steps to Successful Breastfeeding (Ten Steps). The tool identifies, or crosswalks, which items from CDC's Maternity Practices in Infant Nutrition and Care (mPINC™) survey align with each step. The Ten Steps are based on WHO's and UNICEF's evidence-based Implementation Guidance – Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services: the revised Baby-friendly Hospital Initiative 2018.

This tool is intended for:

• State and local health departments.
• Breastfeeding coalitions.
• Institutions and organizations working with hospitals to improve maternity care practices.

Hospitals can also use the tool to assess their own implementation of the Ten Steps. In addition, hospitals can use the tool to highlight areas of strength and those that need improvement. This tool can help guide implementation of maternity care practices and policies supporting breastfeeding. It can also help identify and prioritize improvement efforts.

This tool does not correspond to, or replace, Baby-Friendly USA's on-site assessments or the Baby-Friendly designation.

Although this tool assesses many aspects of each of the Ten Steps, it does not assess every aspect. Every aspect of each step cannot be assessed using mPINC data alone. This tool is not an additional mPINC™ survey. Instead, it presents a crosswalk between mPINC items and the Ten Steps. The tool is designed to help with assessment efforts.

mPINC™ and the Ten Steps

CDC's mPINC survey is a national survey of maternity care practices related to breastfeeding. Approximately every other year, facilities routinely providing maternity care in the United States and territories are invited for survey participation. Only hospitals and birthing centers inside hospitals are eligible to participate. As of 2018, freestanding birth centers are not eligible to participate.

CDC calculates total mPINC scores for all participating hospitals. These scores indicate hospitals' overall level of maternity care practices and policies that support optimal infant feeding. CDC also calculates subscores across multiple maternity care practice subdomains. CDC sends hospitals these scores and their responses to each scored mPINC item in their mPINC Hospital Report.

The mPINC scoring algorithm is not aligned with the Ten Steps. A hospital's total mPINC score or subscores do not necessarily indicate how well a hospital has implemented the Ten Steps. However, a hospital can use many mPINC items and responses to help assess how it implements each of the Ten Steps. This tool is designed to help with this process.