Infant Health

  • Breaking Barriers to Healthy Birth Spacing in Underserved Populations

    Posted October 18, 2016 by Elizabeth Barker

    For women who have recently given birth, waiting at least 18 months before becoming pregnant again is essential as it allows the body much-needed time to recover and heal. Longer intervals between pregnancies also mean better birth outcomes and healthier babies. While there is no consensus on optimal interpregnancy interval, research shows that short intervals of less than 18 months and intervals longer than 60 months are associated with poor health outcomes.

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  • Medicaid Incentives for Effective Contraceptive Use and Postpartum Care

    Posted October 11, 2016 by Carrie Hanlon

    Unplanned and complex births carry potentially avoidable health complications and costs to families and states. Broad healthcare payment and delivery reform is underway across the country to improve outcomes, enhance patient experience and reduce costs. Some states are capitalizing on these reforms to promote planned and healthy births by driving improvement in effective contraceptive use and postpartum follow up care. Their efforts create potential opportunities for cross-agency collaboration and integrate well with other initiatives, such as the Centers for Medicare and Medicaid Services’ Maternal and Infant Health Initiative and the Health Resources and Services Administration’s Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN).

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  • Raising Awareness of the Impact of Early Childhood Trauma

    Posted October 06, 2016 by Bethany Applebaum; Cherri Pruitt

    Early childhood trauma – whether from unexpected acts of violence or entrenched, continuous influences such as chaotic home life or family violence – is pervasive and can have cumulative, life-altering impacts. The stress of childhood trauma releases hormones that physically damage a child’s developing brain. Children with toxic stress live most of their lives in flight or fight mode, making it difficult to learn in school and build healthy relationships.

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  • PATCH-ing up Communication Between Providers and Teenagers

    Posted September 27, 2016 by Josh Grant

    The Wisconsin Providers and Teens Communicating for Health (PATCH) program is helping to reduce teen pregnancy rates in Wisconsin by enhancing communication between teenagers and their healthcare providers. The PATCH program trains and employs Teen Educators who then educate medical professionals on how to communicate with younger patients, with a particular focus on sensitive subjects, including sexual and reproductive health.

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  • Missouri is Bringing Risk Appropriate Care to its Moms and Babies

    Posted September 20, 2016 by Josh Grant

    Missouri aims to move the state’s hospitals away from self-designation for levels of risk appropriate care to better support perinatal regionalization—the idea that a system exists to designate where babies are born or transferred according to the level of care they need at birth—and improve health outcomes for moms and babies.

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  • How Asking One Key Question Helps Moms and Healthcare Providers Prepare for Pregnancy

    Posted September 13, 2016 by Josh Grant

    A healthy pregnancy starts before conception, but almost half of pregnancies in the U.S. are unplanned. This increases the risk of poor outcomes for both moms and babies. Planning can help women better prepare themselves for pregnancy, and it all starts with a single question from their doctors: Would you like to become pregnant in the next year? The One Key Question® (OKQ) initiative from the Oregon Foundation for Reproductive Health (OFRH) encourages healthcare providers to ask every woman this specific question because it changes the context of other health factors.

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  • Infographic – America’s Problem: Infant Mortality

    Posted September 07, 2016 by Josh Grant

    Although great strides have been made in recent years, infant mortality remains a problem in the United States. The infant mortality rate has declined – dropping 13 percent between 2005 and 2013 – while still leaving the U.S. far behind many industrialized nations.

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  • Preventing Preterm Labor in At-Risk Moms in Underserved Populations

    Posted August 09, 2016 by Elizabeth Barker

    Carrying to full term helps safeguard against some of the greatest threats to infant health. Affecting about 1 in 10 babies born in the United States, preterm birth (i.e., birth before 37 weeks gestation) is a leading cause of infant mortality and a major contributor to long-term disability. Meanwhile, early-term infants (those born at 37 to 38 weeks) are more likely to struggle with low blood sugar, difficulty breathing and other health issues requiring admission to the neonatal intensive care unit (NICU).

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  • The Journey to LOCATe Levels of Neonatal & Maternal Care

    Posted August 04, 2016 by Josh Grant

    The Centers for Disease Control and Prevention’s (CDC) Levels of Care Assessment Tool (LOCATe) is assisting states and jurisdictions by assessing neonatal and maternal levels of care in their birthing facilities. This assessment creates opportunities for conversations among stakeholders to discuss risk-appropriate care, a strategy to reduce infant mortality and improve maternal and child health outcomes.

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  • Smoking & Pregnancy in Underserved Populations: Overcoming Obstacles to Cessation Success

    Posted August 02, 2016 by Elizabeth Barker

    For women who smoke, quitting before or during pregnancy is one of the most powerful ways to improve birth outcomes and protect infants’ health. Not only known to damage the baby’s heart, lungs and brain and increase risk of birth defects, smoking during pregnancy is also closely associated with two leading causes of infant mortality: pre-term birth and sudden infant death syndrome.

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  • Closing the Gaps in Safe Sleep Education in Underserved Populations

    Posted July 26, 2016 by Elizabeth Barker

    While the country’s rate of sudden infant death syndrome (SIDS) has dropped by more than 50 percent over the past two decades, SIDS continues to claim the lives of about 1,500 U.S. infants each year. SIDS is the leading cause of death for infants and is highly correlated with unsafe sleep practices, which is why the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) has made safe sleep practices one of its six focus areas. By helping to eliminate persistent but avoidable disparities in SIDS rates, addressing unsafe sleep practice with underserved populations can reduce infant mortality for all.

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  • Babies in Utero Experience Effects of National Opioid Addiction Epidemic

    Posted July 21, 2016 by Wendy Loveland

    Opioid abuse is at a crisis point in the U.S., and it’s affecting more and more babies in utero. Babies born to women who use opioids are cutoff from those drugs at birth, which puts the babies at risk for a cluster of neurological, gastrointestinal and respiratory symptoms that are collectively referred to as neonatal abstinence syndrome (NAS). Nationally, NAS has increased fivefold since 2000, and this rate, too, has become steeper in the past few years. In 2009, one infant was born with NAS per hour. By 2012, one baby was born with NAS every 25 minutes.

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  • How Can Maternal Mental Health Be Improved During and After Pregnancy?

    Posted July 12, 2016 by Josh Grant

    Maternal mental health is a key part of moms’ and children’s health outcomes. According to the World Health Organization, 10 percent of pregnant women and 13 percent of postpartum women have mental health concerns, such as depression. Fortunately, these cases are largely treatable, especially if doctors are able to intervene early on.

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  • How Sharing Data Can Help Cities and States Reduce Infant Mortality

    Posted June 23, 2016 by Josh Grant

    Data sharing is one of the most significant barriers between city and state health departments when it comes to reducing infant mortality. States and cities accumulate a great deal of data at various levels on birth outcomes and maternal care, but they don’t always make it readily available to each other.

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  • Innovations and Inspirations for Improving Children’s Health: June 2016

    Posted June 21, 2016 by Josh Grant

    Programs from healthcare providers, government agencies and other organizations help improve children's health by addressing new needs and closing gaps in care. This month, we've found innovative and inspirational examples touch on subjects like children's sleep during hospital stays and efforts to improve in-school care.

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  • NICHQ’s Sickle Cell Work Highlighted in Special Supplement to AJPM

    Posted June 16, 2016 by Cindy Hutter

    Two articles related to NICHQ’s portfolio of sickle cell projects are featured in a special sickle cell supplement of the American Journal of Preventive Medicine out today, in advance of World Sickle Cell Day June 19.

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  • Clinicians and Patients Work Together to Improve Preconception Health in the U.S.

    Posted June 14, 2016 by Sarah Verbiest, DrPH, MSW, MPH

    Fostering the creation of healthy families by choice, not chance, is not a new idea. Organizations and agencies are working to improve pregnancy planning, spacing and preventing unintended pregnancies. Given the high rates of unintended pregnancy in the U.S., action is needed from all stakeholders–consumers, health providers, policy makers–in proactively supporting this critical conversation.

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  • Ten Steps to Successful Breastfeeding Videos Showcase Strategies for Successful Implementation

    Posted June 07, 2016 by Cindy Hutter

    A new video series is showcasing how healthcare providers in Texas are successfully implementing the Ten Steps to Successful Breastfeeding, a set of evidence-based practices hospitals can follow to increase breastfeeding initiation and duration by new moms. Created by the Texas Department of State Health Services, this 10-video series features healthcare providers sharing their strategies for success on the pathway to improvement.

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  • Innovations and Inspirations for Improving Children’s Health: May 2016

    Posted May 19, 2016 by Josh Grant

    Across the United States, organizations and government agencies are creating new approaches to improve children’s health. Because we support innovation for helping children lead healthier lives, we’ve highlighted some of the most exciting initiatives we’ve seen in the last few weeks. Read on to learn how some groups are addressing critical health needs.

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  • Boxing Out Unsafe Sleep Practices for Babies

    Posted May 10, 2016 by Josh Grant

    In the 1930s, Finland’s infant mortality rate reached 65 deaths per 1,000 live births, leading to the 1938 introduction of baby boxes—kits that include a mattress, bedding, diapers, a box that serves as a crib and other necessities. By 2015, that rate had dwindled to an estimated 2.52 deaths per 1,000 live births. In 2014, there were 3,500 sudden unexpected infant deaths in the United States, 25 percent of which were caused by accidental suffocation or strangulation in bed. Learning from Finland’s success, organizations in the U.S. are beginning to offer their own baby boxes to new families.

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  • Rhode Island Targets Social Factors to Achieve Health Equity

    Posted May 05, 2016 by Rachel Kremen

    While a higher percentage of Rhode Islanders have health insurance compared to the U.S. average, achieving health equity has been a challenge for the state—especially for its infant mortality rate. Now, the Rhode Island Department of Health is targeting key social factors that impact infant mortality in minority groups, including education, income and stress. The Rhode Island Commission for Health Advocacy and Equity was created in 2011 to address the inequity, by bringing together state agencies to focus on the social determinants of health—typically defined as the wider set of forces and systems shaping the conditions of daily life. Aligning the efforts of those inside and outside the state is also key.

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  • Medicaid Strategies to Promote Full-Term Births

    Posted May 03, 2016 by Tamara Kramer

    Reducing the rate of pre-term birth is a major priority for state health agencies and a growing concern for state Medicaid programs. Medicaid agencies provide coverage for over half of the nation’s births each year and pay for a higher rate of premature or low-birth weight babies than the private insurance market (10.4 percent versus 9.1 percent). Pre-term birth, a birth that occurs prior to 37 weeks of gestation, is the leading cause of infant mortality in the United States. Early delivery is associated with a host of long-term health issues for the infant, including sight and hearing loss, cerebral palsy and developmental and intellectual disabilities.

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  • Why I Participate: By Parent Partner Mercédez Cahue

    Posted March 31, 2016 by Mercédez Cahue

    Mercédez Cahue shares her breastfeeding experience and why she joined the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative as a parent partner.

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  • Just Download It: Wyoming Discovers Novel Way to Help Pregnant Mothers

    Posted March 29, 2016 by Cindy Hutter

    Wyoming is improving its birth outcomes one downloader at a time. An interactive mobile app—Due Date Plus—that the state Medicaid office developed for pregnant women is redefining prenatal education and transforming how Medicaid meets the needs of its pregnant population.

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  • Focusing on Population-Level, Collaborative, Perinatal Outcomes Improvement

    Posted March 24, 2016 by Ed Donovan

    It is becoming increasingly clear that efforts to improve risk-appropriate site of delivery may benefit from close collaboration among perinatal care providers, payers and public health organizations. State health departments and state hospital associations often manage repositories of population-level perinatal data while perinatal quality collaboratives can engage front-line providers. Collaborative partnerships among these entities can facilitate improved outcomes at the population level.

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  • Better Care for High-Risk Babies: Improving Perinatal Regionalization in Illinois

    Posted March 10, 2016 by Elizabeth Baker

    An ongoing effort from the Illinois team involved in the Collaborative Improvement and Innovation Network to Reduce Infant Mortality (IM CoIIN) is to get 90 percent of very preterm infants in Illinois delivered in Level 3 perinatal facilities. These facilities feature neonatal intensive care units (NICUs), where a combination of leading-edge technology and specially trained staff can vastly improve health outcomes for high-risk babies.

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  • WIC Reps Bridge Gap Between Community and Hospitals through Breastfeeding Support

    Posted March 08, 2016 by Sonya Spillmann, RN

    With both large urban and rural areas in Texas, sharing consistent and accurate information about the benefits of breastfeeding with mothers and healthcare workers is an enormous undertaking. One statewide initiative, the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative, is harnessing the power of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) staff, using them as conduits for communicating evidence-based practices and offering guidance to both mothers and healthcare providers.

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  • South Carolina Finds Winning Strategy to Reducing Unintended Pregnancies in its Medicaid Population

    Posted March 01, 2016 by Wendy Loveland

    In South Carolina, half of all pregnancies in 2010 were unintended, primarily due to either lack of or failed contraceptives. Within the South Carolina Medicaid population, almost 79 percent of women defined their pregnancy as unintended. This is particularly troubling because births resulting from unintended pregnancies are linked to adverse maternal and child health outcomes and myriad social and economic challenges. To reduce this percentage, South Carolina Medicaid began a policy change in 2012 aimed at increasing the use of immediate postpartum inpatient insertions of long-acting, reversible contraceptives (LARCs).

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  • Second-Time Moms Appreciate Hospital Changes to Support Breastfeeding

    Posted February 23, 2016 by Rachel Kremen

    When Nicole Acosta delivered her first child in May 2013, she knew she wanted to breastfeed, but she didn’t get as much support as she’d expected at her hospital, Good Samaritan Medical Center in West Islip, NY. Despite an uncomplicated delivery, no one suggested immediate skin-to-skin contact—a practice known to increase the likelihood of breastfeeding success. By the time she had her second son in June 2015, things had certainly changed at the hospital.

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  • New CDC Data Shows More Work Needed to Curb Smoking During Pregnancy

    Posted February 19, 2016 by Sabrina Selk

    It has been more than 50 years since the Surgeon General’s report on the adverse health impacts of smoking. However, maternal smoking during pregnancy remains a persistent problem that healthcare and public health professionals have been unable to eliminate.

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  • NYS Hospitals See Dramatic Results in Breastfeeding Collaborative

    Posted February 17, 2016 by Cindy Hutter

    Recruitment is open for hospitals in New York State to join the state’s Breastfeeding Quality Improvement in Hospitals (BQIH) Learning Collaborative. If the results of the predecessor cohort of hospitals is any indication, these new recruits are in for some big changes.

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  • How Kansas is Leveraging the Infant Mortality CoIIN to Accelerate Improvement

    Posted February 11, 2016 by Cindy Hutter

    Collaborative Improvement and Innovation Networks (CoIINs) offer many tools and resources for their participants. From driver diagrams to measurement strategies to change packages and collaboration tools, the underlying supports for accelerating change are all there. A participant just needs to reach out and embrace them.

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  • The Long-Term Value of Better Breastfeeding Support

    Posted February 09, 2016 by Liz Barker

    For hospitals and patients alike, the benefits of boosting breastfeeding support last far beyond any hospital stay. Investing in improved maternity practices can lead to major quality gains, jumps in patient satisfaction, and slashed healthcare costs—not to mention its power to drive up breastfeeding rates and protect the health of both moms and babies.

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  • The Value of Increasing Exclusive Breastfeeding along the Texas-Mexico Border

    Posted February 04, 2016 by Wendy Loveland

    A baseline report shows that only 15 percent of infants born in South Texas (Health Service Region 11) in 2009 were exclusively breastfed on their second day of life compared to 42 percent of infants in Texas overall, and as many as 55 percent in other parts of the state. An increase in exclusive breastfeeding in the Valley could not only increase the state’s overall rate, but could provide a roadmap for other similar communities to follow to improve the health of their residents.

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  • Protecting Babies From Sleep-Related Deaths Starts With Painting a Clear Picture

    Posted January 28, 2016 by Cindy Hutter

    Today’s parents and parents-to-be rely a great deal on the Internet, print and broadcast media to inform their childcare and parenting practices. Yet in a recent study of magazines targeting women of child-bearing age, more than one-third of images showed babies in unsafe sleep positions (e.g., on their stomachs) and more than two-thirds showed babies in unsafe sleep environments (e.g., in a crib with blankets). Thousands of precious lives could be saved each year if every parent and caregiver had a clear picture of what it takes to protect their babies during sleep.

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  • Join Interactive Webinar on Improving the Health of New Mothers

    Posted January 26, 2016 by Cindy Hutter

    NICHQ, along with partners AMCHP and the UNC Center for Maternal and Infant Health, is turning the session “Improving the Health of New Mothers: Building Woman‐Centered Postpartum Systems of Care” into a free public webinar. We invite you to join us on Feb. 2, from 3:30-5 p.m. ET

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  • Moms Deserve Better Care In The Fourth Trimester

    Posted January 20, 2016 by Alison Stuebe

    In the weeks following childbirth, mothers must adapt to plunging hormones, recover from birth and learn how to feed and care for a new infant. Amid these challenges, moms receive minimal support from the healthcare system. Postpartum visits are typically scheduled four to six weeks after birth, leaving moms to cope on their own for more than a month. Moms need more support in the weeks following birth.

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  • Supporting Breastfeeding Across A Hospital System

    Posted January 04, 2016 by Wendy Loveland

    Changing a habit is not easy, even when you know it is “good for you.” The same goes for changing healthcare systems. The benefits of breastfeeding are well known, and supported by the World Health Organization, the Joint Commission, and many other healthcare accreditation and oversight agencies and experts. However, many hospitals struggle to create environments that support mothers who choose to breastfeed.

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  • Find Success and Mirror It - Can It Be That Simple?

    Posted December 12, 2014 by Elissa Faro, PhD

    Childhood malnutrition. Infant mortality. Childhood obesity. Health inequalities and disparities. These are just some of the most demanding problems facing those who work to improve child health. However, these big issues are often seemingly intractable. How do you move the needle when previous efforts have yielded such meager results? One answer may lie in the concept of positive deviance.

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  • Contradicting Assumptions About Infant Mortality Rates: How Far Upstream?

    Posted November 04, 2014 by Charles J. Homer, MD, MPH

    Learning often begins when facts contradict our assumptions. While attending the kickoff summits of the Collaborative Improvement and Innovation Network (CoIIN) to Reduce Infant Mortality in July, I became aware of at least two facts that contradicted my previous assumptions: (1) that infant mortality rates for non-Hispanic blacks are higher in the upper Midwestern states than they are in the deep South and (2) that the declines in infant mortality in several southern states over the past decade have been steeper than anywhere else in the country.

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  • Improvements in Maternity Care Practice Are Not Easy

    Posted September 22, 2014 by Lori Feldman-Winter, MD, MPH

    As NICHQ’s faculty chair for Best Fed Beginnings, a national initiative that supports hospitals seeking Baby-Friendly designation, I am frequently exposed to pushback regarding the improvements required for a hospital to achieve this designation. Recently, an article published in the Washington Post portrayed Baby-Friendly practices as a problematic set of policies that “force” a new mother to breastfeed against her wishes. Nothing could be farther from the truth.

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  • Why I Struggled to Find My Breastfeeding North Star

    Posted August 27, 2014 by Katrina McCarty, MPA

    As a new mom, I found myself searching for a true guiding presence as I tried to make decisions about caring for my daughter and myself. I knew I wanted to breastfeed her and I assumed it would be easy. I assumed the stars would align and she and I would be deliriously connected and she would be nourished. I assumed a hungry baby and a food source were enough. Not quite.

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  • A Busy Summer: Building Blocks, Babies and Breastfeeding

    Posted August 15, 2014 by Meghan Johnson, MSc

    August is typically a month for relaxing, vacationing and taking long weekends to enjoy the warm weather. At NICHQ, we get our share of R & R, but August 2014 is also a particularly busy and exciting time! In August, we celebrate National Breastfeeding Month and World Breastfeeding Week (August 1-7), and as part of that, I am excited to help launch NICHQ’s new breastfeeding project with the New York State Department of Health.

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  • Communicate, Collaborate and Innovate to Reduce Infant Mortality

    Posted July 02, 2014 by Peter Gloor, PhD

    Compared to other Western countries, infant mortality in the US is shockingly high. High infant mortality is a social problem that can only be solved through massive collaboration and out-of-the-box innovation.

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  • What Rosie Revere, Engineer Teaches Me About Innovation

    Posted February 19, 2014 by Marianne McPherson, PhD, MS

    I’ve been thinking about innovation a lot lately, in large part due to a renewed commitment at NICHQ to be a hub for creating and spreading innovations. I am so excited about this commitment because I know that new ideas and new approaches—and building them together—will help create a world in which all children achieve their optimal health.

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  • When Did Breastfeeding Become a Choice?

    Posted January 09, 2014 by Jennifer Ustianov, RN, BSN, IBCLC

    I know the tides are beginning to turn. Recent reports show breastfeeding rates are increasing in the US. The journey back to a more supportive breastfeeding culture has begun in this country. But I wonder whether there is more we can do to accelerate this process, so that from this generation forward there is no question and no need to choose.

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