Hospital support for breast-feeding has improved, according to a report card from the Centers for Disease Control and Prevention.

Since 2009, 47 states and the District of Columbia have increased their score on the CDC’s Maternity Practices in Infant Nutrition and Care survey, which measures the degree to which practices in U.S. hospitals support breast-feeding. Additionally, births at designated baby-friendly hospitals have increased from 1.93% in 2008 to 6.22% in 2012.

This year’s report card also found that the proportion of mothers who begin breast-feeding increased from 74.6% in 2008 to 76.9% in 2009, the largest one-year increase in a decade. However, fewer than half (47%) of mothers are still breast-feeding at six months, and only a quarter are still breast-feeding at 12 months.

In addition, breast-feeding rates among states vary greatly. Less than half of mothers begin breast-feeding in Mississippi. Less than a third of mothers are still breast-feeding at six months in Alabama, Arkansas, Kentucky, Louisiana, Mississippi and West Virginia. Meanwhile, more than 90% of mothers start breast-feeding in Idaho, and more than 60% are still breast-feeding at six months in New Hampshire, Oregon, Utah and Vermont.

Continued support for breast-feeding, with a focus on hospital support, is one way to improve breast-feeding rates and should continue to be a priority, according to the CDC. Although the number of births in baby-friendly hospitals is increasing, most U.S. hospitals still lack the designation. This dearth indicates mothers are not getting the quality of care they need.

The report card is available at http://1.usa.gov/NXAHZ1. More on the baby-friendly designation is available at www.babyfriendlyusa.org/eng/01.html.