Better Breastfeeding for Healthier Moms and Babies
Both mothers and babies experience life-long benefits from breastfeeding. Multiple cancer and disease risks are lowered for breastfeeding mothers, and breastfed babies show a reduction of a range of health concerns, from leukemia to asthma to infection. Yet breastfeeding remains a significant public health issue, with national averages falling below the Healthy People 2020 objectives. As a result, thousands of mothers and babies will miss out on the health benefits of breastfeeding.
Over the course of three sequential cohorts, NICHQ instructed 74 hospital-based teams on quality improvement (QI) methodology, providing specific and actionable strategies to create lasting organizational change and track progress in breastfeeding outcomes. All strategies supported the recommendations from the Texas 10 Step Program, developed to improve maternity care practices in Texas birthing facilities. Through monthly coaching calls, in-person learning sessions, site visits and an online collaborative community, teams received guidance on how to use QI methodology to introduce and implement evidence-based breastfeeding practices at their facilities. The QI methodology focused on collecting data for learning, using small tests of change for improvement and a collaborative learning environment where teams could steal shamelessly and share seemlessly. This approach provided rigor, structure and peer learning as teams sought to increase breastfeeding rates in their hospitals.
NICHQ has impacted the lives of 152,000 mothers and infants who received maternity care at the 74 hospitals during the project period. Over the course of the initiative,
- Texas 10 Step facilities increased by 47 percent
- Baby-Friendly facilities increased by over 200 percent
- Breastfeeding outcomes were significantly impacted for Hispanic and African American infants
- Community partnerships between WIC and hospital initiatives were solidified, benefiting the many hospitals nationwide serving WIC-eligible mothers and infants
Signals of future change:
While changes to exclusive breastfeeding rates often take years to capture, multiple hospitals have already shown significant improvement, indicating future success across the collaborative. The results from three separate hospitals, which we’ve been asked to de-identify, are shown below:
- Hospital A saw exclusive breastfeeding rates increase from 19 to 43 percent
- Hospital B showed an increase of 37 to 46 percent in its exclusive breastfeeding rate
- Hospital C showed an increase of 27 to 40 percent in its exclusive breastfeeding rate
The culture of breastfeeding in Texas has radically changed over the course of the five-year improvement initiative. There are now 131 hospitals with the Texas 10 Step designation and 22 organizations designated as Baby-Friendly or on the Baby-Friendly pathway. With Texas representing 10 percent of births in the U.S. each year, this improvement has national implications. By putting in place a quality improvement framework focused on collaborative learning and vast stakeholder engagement, NICHQ has paved the way for Texas to continue to improve maternity care practices and breastfeeding rates across the state. And due to Texas’ wide geographic expanse and diverse population, their achievements provide a comprehensive model for breastfeeding improvement efforts in other states and regions.
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What People Say
I really can't say enough good things about what your NICHQ team has done to help us get things moving in Texas! I have loved working with all of you and have learned so much from everyone.
Being a parent partner for NICHQ ...has been a pure honor. I would encourage anyone that has the opportunity to work on a NICHQ project to take advantage of it. Working with them has opened many doors for me in the medical field.
I have been impressed to see the policy changes across our state take hold, moving toward a new care standard and I am optimistic about the changes which are continuing throughout our state.
From the very first meeting, they embraced what we're trying to do in Texas and never missed a beat... It's a pretty well-oiled machine and it's been exciting to work with them.
NICHQ's team brought enthusiasm, structure and information about how to effectively implement change management to the project which has been key to the success of the collaborative. I continue to look forward to guidance and support from NICHQ for similar projects in the future.
Applying an Equity Lens to Safe Sleep and Breastfeeding Efforts
Black families are twice as likely as white families to have their baby die in the first year of life. In some states, they are three times as likely. These statistics are more than numbers; they represent real families who suffer unimaginable loss—loss that stems from the persistent effects of systemic racism on the health of black families. Here, faculty experts on a national safe sleep and breastfeeding initiative share their recommendations for how health professionals and improvement initiatives can better support the health and well-being of black families.
Breastfeeding in 2019: Safe Sleep, Bias, Gender Equitable Norms, and Paid Leave
In honor of National Breastfeeding Month, we’ve taken time with NICHQ Faculty Expert, Lori Feldman-Winter, MD, MPH, an internationally and nationally recognized expert on breastfeeding nutrition, education and policy, to recognize successes and learn about opportunities for improvement. Her frank description of bias and her passion for promoting gender-equitable social norms have inspired us to continue pursuing sustainable improvements.
Fathers: Powerful Allies for Maternal and Child Health
Supporting father engagement and involvement is a critical opportunity to improve children’s health outcomes in the decades to come, says NICHQ President and CEO Scott D. Berns. Here, he describes three strategies for supporting fathers as powerful allies in maternal and child health outcomes.
Interrupting the Mother-Child Dyad is Not the Answer to Infant Safety
Rooming-in not only has the potential to improve health outcomes for moms and babies, but it is a critical strategy for closing equity gaps in breastfeeding and, in turn, equity gaps in maternal and infant health. Recently though, questions about infant safety and rooming-in have arisen due to worries that an already exhausted mother may fall asleep while breastfeeding her baby. Here, three experts off advice on keeping moms and babies together safely so that both can benefit from this critical practice.
Bringing Breastfeeding Support to More Mothers and Caregivers
In an increasingly digital age, telelactation support is a powerful opportunity to increase breastfeeding rates among amothers who can't access classes. In addition to over the phone, lactation consultants and counselors can support moms through video chats like Skype, via text message or in online communities.
A Better Approach to Conversations about Breastfeeding
Without hearing directly from mothers, health professionals can’t provide meaningful education and support that speaks to each mother’s individual views and experiences. This is one reason why improving conversations with breastfeeding mothers can help increase breastfeeding rates. Here, two experts offer advice on how put a better conversational approach into action.