March 27, 2012

Experts Weigh In on Boosting Breastfeeding Support

Health practitioners set strategy for national breastfeeding initiative

By Kristina Grifantini

On March 7, 2012, the National Initiative for Children’s Healthcare Quality (NICHQ) gathered nationally known experts in maternity care to recommend strategies for improving hospital practices to support breastfeeding. These strategies will set the basis for the country-wide improvement program, Best Fed Beginnings, run by NICHQ and supported by the Center for Disease Control and Prevention (CDC), in close partnership with Baby-Friendly USA.

The experts discussed how hospitals can make improvements to reach “Baby Friendly” status, which will be the primary goal for hospitals participating in the Best Fed Beginnings project. Baby-Friendly USA gives this designation to maternity services in the United States that adhere to ten specific steps—such as maintaining a written breastfeeding policy and eliminating the use of pacifiers—as outlined by the World Health Organization and UNICEF.

Like most of NICHQ’s projects, Best Fed Beginnings takes advantage of a tried-and-true quality improvement method for bringing beneficial and sustainable changes to healthcare systems. The Expert Meeting, where a diverse group of professionals establish the project’s goals, is the first step in the process.

Less than 4% of U.S. hospitals provide full support for mothers to breastfeed, despite research showing that babies who breastfeed are less likely to suffer death, many infectious diseases and even adult obesity compared to their formula-fed counterparts, according to the CDC.

“It’s such an important project,” said Karen Peters, the executive director of the Breastfeeding Task Force of Greater Los Angeles, who attended the Expert Meeting. “I didn’t realize how monumental this would be in terms of accelerating the changes across hospitals.”

Professor Miriam Labbok, Director of the Carolina Global Breastfeeding Institute in the UNC Gillings School of Global Public Health, also expressed enthusiasm at the meeting. “[We] will continue to offer whatever we learn from all of our research and projects to this effort,” she said. “If we achieve the increased practice of the Ten Steps envisioned, it will be monumental for the United States.”

Other professionals who attended the Expert Meeting included: William Rhine (Stanford University), Delvecchio Finley (Harbor UCLA Medical Center), Trish MacEnroe (Baby-Friendly USA), Eileen Magri (Winthrop Hospital), Joshua Johannson (Penn Medicine), Trina Histon (Kaiser Permanente), Patricia Waniewski (New York State Department of Health), Carol Melcher (Loma Linda University Medical Center), Becky Mannel (Oklahoma University Medical Center), Mary Applegate (Ohio Medicaid), Kim Bugg (Reaching Our Sisters Everywhere) and partners from the CDC and NICHQ.

A major outcome from the meeting was consensus on what key changes are needed to achieve improvements to support breastfeeding in hospitals. The Expert Meeting attendees also discussed measurements hospital teams can use to track their progress. The expert attendees agreed that, in addition to how often a mother breastfeeds, other useful measurements include: the minutes of skin-to-skin contact between mothers and their newly born infants, the amount of time an infant is in the room with the mother, and the number of mothers told about resources for breastfeeding, such as information on lactation consultants. The meeting also provided valuable input for finalizing guidelines that hospital teams will use to make the changes.

“If we can learn and share internally and externally, we can advance together,” said Histon, who added that the meeting inspired her to bring back ideas to Kaiser.

In the next step of the improvement process, NICHQ will select 90 hospitals to participate in the Best Fed Beginnings Learning Collaborative, in which they will learn how to plan, test and implement local changes to better support mothers and babies to breastfeed. Hospitals or health-care professionals interested in learning more or applying to the 22-month Collaborative can visit our information page.