Case Studies
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.
Our Approach
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.
The Results
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
Impact
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.
