New York State's Paid Family Leave Program is Associated with More Equitable and Increased Use of Paid Leave Following Childbirth.

OBJECTIVES: This study aimed to assess changes in paid maternity leave before and after New York's (NY) Paid Family Leave (PFL) law went into effect (1/1/2018) and changes in disparities by maternal characteristics. METHODS: We used specific data collected on maternity leaves by women who gave birth in 2016-2018 in NY State (outside NY City) participating in the Pregnancy Risk Assessment Monitoring System survey. Multiple logistic regressions were conducted to evaluate the effect of the PFL law on prevalence of paid leave taken by women after childbirth. RESULTS: After NY's PFL law went into effect, there was a 26% relative increase in women taking paid leave after childbirth. Use of paid leave after childbirth increased among all racial and ethnic groups. The increases were greater among Black non-Hispanic or other race non-Hispanic women, compared to white non-Hispanic women, suggesting that NY's law was associated with more equitable use of paid leave following childbirth. CONCLUSIONS FOR PRACTICE: Wider implementation and greater utilization of paid maternity leave policies would promote health equity and help reduce racial/ethnic disparities in maternal and child health outcomes.

New York State Paid Family Leave Law Associated with Increased Breastfeeding Among Black Women.

Background: While breastfeeding has increased during the past 50 years, disparities continue, with Black women having the lowest rates. Use of paid leave has been associated with longer breastfeeding duration. Objective: Evaluate the impact of New York (NY)'s Paid Family Leave (PFL) law on breastfeeding, after it became effective on January 1, 2018. Materials and Methods: Women in NY (excluding NY City), who gave birth in 2016-2019 and completed the Pregnancy Risk Assessment and Monitoring System (PRAMS) survey, were included. Data from PRAMS and the NY State Expanded Birth Certificate were combined. Changes in breastfeeding initiation and duration and use of paid leave were compared, before and after NY's PFL law became effective, with separate analysis by sociodemographic factors. Results: Before NYPFL, Black women were least likely to initiate breastfeeding and breastfed for the shortest duration. After NYPFL went into effect, breastfeeding initiation and duration to 8 weeks increased for Black women, but not for other racial/ethnic groups; these findings persisted after adjustment for sociodemographic factors. Use of paid leave after childbirth increased 15% overall, with greater increases among Black women and Hispanic women. Conclusions: Implementation of the NYPFL law was associated with increased breastfeeding among Black women and increased use of paid leave by all. Greater increases in breastfeeding among Black women significantly reduced breastfeeding disparities by race/ethnicity. More widespread implementation of PFL programs in the United States would promote equity in the use of paid leave, which could reduce disparities in breastfeeding initiation and duration and possibly improve infant and maternal health outcomes.

Development of the breastfeeding quality improvement in hospitals learning collaborative in New York state.

Exclusive breastfeeding is a public health priority. A strong body of evidence links maternity care practices, based on the Ten Steps to Successful Breastfeeding, to increased breastfeeding initiation, duration and exclusivity. Despite having written breastfeeding policies, New York (NY) hospitals vary widely in reported maternity care practices and in prevalence rates of breastfeeding, especially exclusive breastfeeding, during the birth hospitalization. To improve hospital maternity care practices, breastfeeding support, and the percentage of infants exclusively breastfeeding, the NY State Department of Health developed the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. The BQIH Learning Collaborative was the first to use the Institute for Health Care Improvement's Breakthrough Series methodology to specifically focus on increasing hospital breastfeeding support. The evidence-based maternity care practices from the Ten Steps to Successful Breastfeeding provided the basis for the Change Package and Data Measurement Plan. The present article describes the development of the BQIH Learning Collaborative. The engagement of breastfeeding experts, partners, and stakeholders in refining the Learning Collaborative design and content, in defining the strategies and interventions (Change Package) that drive hospital systems change, and in developing the Data Measurement Plan to assess progress in meeting the Learning Collaborative goals and hospital aims is illustrated. The BQIH Learning Collaborative is a model program that was implemented in a group of NY hospitals with plans to spread to additional hospitals in NY and across the country.

Improving maternity care practices in New York: answering the Surgeon General's Call to Action.

Hospitals providing maternity care influence breastfeeding mothers and infants during the critical, early postnatal period. Despite concerted public health efforts, there are persistent, large variations across New York State (NYS) hospitals in breastfeeding policies, maternity care, and infant feeding practices and in rates of breastfeeding initiation and exclusivity. An initiative addressing this issue is the Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative, which was designed and implemented by the NYS Department of Health (NYSDOH). The BQIH Learning Collaborative, adapted from the Institute for Healthcare Improvement Breakthrough Series, embedded evidence-based maternity care best practices in a learning and quality improvement model. The Ten Steps to Successful Breastfeeding served as the backbone for improvement with the aims of increasing the percentages of infants fed any breastmilk and exclusively fed breastmilk while decreasing the percentage of breastfed infants supplemented with formula. Twelve hospitals were selected to participate based on their breastfeeding metrics: 10 of the hospitals were low performing, and two were high performing on these breastfeeding measures. During the 18-month BQIH Learning Collaborative, process improvement occurred for several measures, including breastfeeding within the first hour after birth, breastfeeding mother/infant rooming-in, and receipt of formula samples/discharge bags. NYSDOH plans to spread this Collaborative to all hospitals providing maternity care in NYS. Comprehensive breastfeeding initiatives will continue in NYS in the effort to ensure that all breastfeeding mothers receive optimal support from healthcare providers and hospitals with the goal of making breastfeeding the norm for infant nutrition during the first year of life.

Blend uniformity analysis of pharmaceutical products by Broadband Acoustic Resonance Dissolution Spectroscopy (BARDS).

Blend uniformity analysis (BUA) is a routine and highly regulated aspect of pharmaceutical production. In most instances, it involves quantitative determination of individual components of a blend in order to ascertain the mixture ratio. This approach often entails the use of costly and sophisticated instrumentation and complex statistical methods. In this study, a new and simple qualitative blend confirmatory test is introduced based on a well known acoustic phenomenon. Several over the counter (OTC) product powder blends are analysed and it is shown that each product has a unique and highly reproducible acoustic signature. The acoustic frequency responses generated during the dissolution of the product are measured and recorded in real time. It is shown that intra-batch and inter-batch variation for each product is either insignificant or non-existent when measured in triplicate. This study demonstrates that Broadband Acoustic Resonance Dissolution Spectroscopy or BARDS can be used successfully to determine inter-batch variability, stability and uniformity of powder blends. This is just one application of a wide range of BARDS applications which are more cost effective and time efficient than current methods.

Positive effects of family dinner are undone by television viewing.

The purpose of this cross-sectional study was to test the independent associations of eating dinner as a family and having the television on during dinner with child feeding behaviors. Parents/guardians of children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children in New York state were surveyed (n=1,336). Main outcome variables were frequencies of serving fruits, vegetables, and milk. Main exposure variables were the number of days per week the family ate dinner together and the number of days per week the television was on during dinner. Multiple logistic regressions assessed the association between the exposure variables and each of the main outcome measures controlling for race/ethnicity and parental educational attainment. Each night the family ate dinner together was positively associated with serving fruits (odds ratio [OR]=1.14, 95% confidence interval [CI] 1.07 to 1.21) or vegetables (OR=1.15, 95% CI 1.08 to 1.23). Serving fruits (OR= 0.95, 95% CI 0.91 to 0.99) or vegetables (OR=0.94, 95% CI 0.90 to 0.98) decreased with each night the television was on during dinner. Neither family dinner nor television on during dinner was significantly associated with serving milk. Family dinners and dinners without television on are independent predictors of servings of fruits or vegetables offered to preschool children. Because dietary habits and preferences are established early in life, parents should be counseled to promote family meal environments that support healthful eating.