New York Engages Partners to Improve Breastfeeding Outcomes
Studies have shown that breastfeeding is both a risk reduction and health promotion strategy for mothers and babies. From lowering the risk of certain types of breast and ovarian cancer in mothers, to reducing the risk of becoming obese and developing type 2 diabetes in children, the benefits of breastfeeding can be seen across generations. The evidence is strong, yet breastfeeding rates in the U.S. remain well below the Healthy People 2020 objectives. Even more alarming are the substantial racial and ethnic disparities that still exist, with only 33 percent of non-Hispanic black infants and 32 percent of Hispanic infants being exclusively breastfed, compared to 56 percent of white infants.
NICHQ facilitated a pilot and two successive breakthrough series learning collaboratives, allowing hospital improvement teams across New York State to test and implement changes in their maternity care practices shown to support improved breastfeeding outcomes. NICHQ convened hospital administrators, physician champions, staff nurses, family partners and representatives from local Supplemental Nutrition Programs for Women, Infants and Children (WIC) to work collaboratively and better support women and their families to meet their breastfeeding goals. By leveraging the content expertise of local faculty members and training them in quality improvement methodologies, NICHQ presented hospitals with evidence-based strategies and resources to implement sustainable changes in their facilities, which aligned with the Ten Steps to Successful Breastfeeding.
With gaps in maternity practices that support breastfeeding, the state of New York was presented with an opportunity to transform the way hospitals provide care to women and families in their community. The work's results include:
- The hospitals engaged in the two cohorts improved their aggregate exclusive breastfeeding rates by more than 10 percent.
- Two cohorts improved mothers’ abilities to recognize cues that their babies were hungry by 57 percent. Now, more mothers can breastfeed based on their baby’s satiation rather than according to a timed schedule, which promotes breastmilk production and reduces formula over-feeding.
- One cohort increased rooming-in rates by 33 percent. Evidence shows that sharing a room during the hospital stay can help mothers learn feeding cues and establish feeding patterns prior to discharge, thereby increasing the duration of breastfeeding. Now, each year, nearly 30,339 infants benefit from rooming-in during the hospital stay.
- Contributed to five hospitals receiving Baby-Friendly hospital designation. As a result, more families are receiving evidence-based information and support to help them safely initiate and continue breastfeeding. And through participation in this learning collaborative, the remaining 39 hospitals are one step closer to aligning their maternity care practices with the Baby-Friendly requirements.
- Strengthened a partnership between the NYS DOH and the WIC Program at the state and local level, allowing both agencies to collaborate and better coordinate their work so that more hospitals are aware of the breastfeeding support offered by local WIC agencies.
The approximately 62,000 infants born across these New York State hospitals each year are benefiting from environments tailored to support better breastfeeding practices and education. By creating new policies and developing robust partnerships at the state and local level, New York is ensuring that thousands of babies will continue to receive the best start possible.
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What People Say
It has been an honor to work with NICHQ as a Parent Faculty member. I admire how NICHQ continues to center their work around the people directly impacted by it: families and children. They actively work to include these voices throughout project implementation, ensuring that policies remain grounded in patient experiences and feedback. The expertise and professionalism of NICHQ staff has meant that I always feel supported, and confident that all stake holders are included in the process.
I want to tell you how much I have enjoyed and learned from all of you at NICHQ. You are enthusiastic, supportive, smart and FUN. You have talked me off the ledge many times when I wanted to quit. You are true leaders and passionate about what you do.
Working with NICHQ, I have been able to assist communities all over New York State with their breastfeeding care efforts. The NICHQ staff is experienced, organized and thorough, ensuring each interpersonal interaction is maximally engaging and productive. Because of the way change efforts are organized, I find myself learning new procedural and educational techniques, and even more about my own field! Thanks to NICHQ for including me on this interesting ride.
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Persistent and unacceptable disparities in infant mortality and perinatal outcomes affect the health of families in every state in the nation. For the past 30 years, the federal Healthy Start program has provided integral maternal and child health services in communities disproportionately impacted by negative birth outcomes. Now, NICHQ is working with all 101 Healthy Start community sites to harness lessons learned, implement innovative approaches to improvement, and ultimately start to close the disparity gap in maternal and infant health.
The Impact of Institutional Racism on Maternal and Child Health
Embedded within persistent disparities are the ongoing effects of institutional racism—racism that began with the enslavement of Black people, was embedded in our earliest institutions, and has continued to influence policies and practices ever since.
Breastfeeding Priorities: 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.
Closing the Breastfeeding Disparity Gap: Methods for Improvement
When compared to all other racial groups, Hispanic mothers are most likely to supplement breastmilk with formula within the first two days of life. One hospital on the Texas-Mexico border, serving a nearly 100 percent Hispanic population, has introduced a variety of interventions aimed at closing the breastfeeding disparity gap, specifically as it relates to exclusive breastfeeding.
QI Initiative Brings National Changes to Breastfeeding Support
The NICHQ-led Best Fed Beginnings initiative has made it possible for 218,000 more babies to be born in Baby-Friendly hospitals every year. Collaboration was essential because of the complex challenges for creating better breastfeeding support.