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Mass. Baby-Friendly Collaborative

Mass. Baby-Friendly Collaborative. Welcome!!. Background. Informal Collaborative since 2008 Mother-Baby Summit since 2009 DPH Baby-Friendly Trainings Spring 2008. Our Faculty today. Roger Edwards, ScD Mary Ellen Boisvert , RN, MSN, CLC, CCE Lucia Jenkins, RN, IBCLC Mary Foley, RN, IBCLC

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Mass. Baby-Friendly Collaborative

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  1. Mass. Baby-Friendly Collaborative Welcome!!

  2. Background • Informal Collaborative since 2008 • Mother-Baby Summit since 2009 • DPH Baby-Friendly Trainings Spring 2008

  3. Our Faculty today • Roger Edwards, ScD • Mary Ellen Boisvert, RN, MSN, CLC, CCE • Lucia Jenkins, RN, IBCLC • Mary Foley, RN, IBCLC • Judy Fayre, BS, RN, IBCLC • Melissa Bartick, MD, MSc

  4. Today’s agenda • Part I: Information (didactic) • Part II: Hospital working groups • Part III: Based on your feedback on index card, breakout groups based on topics of most interest

  5. Future meetings Eastern Mass Western Mass Holyoke Hospital March 21, 4:30-6:30 Axilliary Conf. Room • Feb 28, 4:30-6:30 • April 4, 4:30-6:30 • Both at Somerville Hospital Cafeteria Conf. Room Whole State Meeting: Thursday, May 2, approx 5:30-7:30 Log Cabin Conference Center, Holyoke MA

  6. Thank you to:UMMMCMass. Breastfeeding CoalitionMass. DPHOur faculty and staff

  7. Website • www.massbreastfeeding.org/collaborative • Meetings times and places & directions • Resources

  8. Baby-Friendly Why it matters Melissa Bartick, MD, MSc Cambridge Health Alliance, Harvard Medical School Mass. Breastfeeding Coalition United States Breastfeeding Committee

  9. Patient-Centered Care 60% of women do not meet THEIR OWN breastfeeding goals. • CDC/FDA Infant Feeding Practices Survey II, 2008

  10. Ten Evidence-based Steps • Written breastfeeding policy & communicate it to staff. • Train all health care staff to implement the policy. • Inform all pregnant women about benefits & management of breastfeeding. • Initiate breastfeeding within an hour of birth. • Show mothers how to breastfeed, and how to maintain lactation. • Give newborn infants no food or drink other than breast milk, unless medically indicated. • Practice rooming-in– allow moms and babies to be together 24 hours a day. • Encourage breastfeeding on demand. • Give no artificial teats or pacifiers to breastfeeding infants. • Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

  11. The 10 Steps: Do they work? . • CDC/FDA Infant Feeding Practices Study II • 1,907 women who intended to bf> 2 months • Measured: Breastfeeding termination at 6 weeks DiGirolamo A, Grummer-Strawn L, Fein S. Pediatrics 2008;122:S43–S49

  12. Surveyed moms on 6 steps: • Breastfeeding within 1 hour of birth • Giving only breast milk • Rooming in • Breastfeeding on demand • Not using pacifiers • Fostering breastfeeding support groups

  13. Results . . . Compared with mothers who experienced all6 steps . . . mothers who experienced no steps were 13 times more likely to stop breastfeeding by 6 weeks. DiGirolamo A, Grummer-Strawn L, Fein S. Pediatrics 2008;122:S43–S49

  14. Most important steps: • Breastfeeding within the first hour of birth • No formula • No pacifiers DiGirolamo A, Grummer-Strawn S, Fein S. Pediatrics 2008;122:S43–S49

  15. This confirms earlier work Most important predictors of weaning by 6 weeks in IFPS I were: • Delayed 1st feed beyond the first hour after birth • Giving formula without a medical reason From IFPS I, 1993-94 DiGirolamo A, Grummer-Strawn L, Fein S BIRTH 28:2 June 2001

  16. PROBIT • Promotion of Breastfeeding Intervention Trial • Kramer et al randomized hospitals and associated clinics in Belarus • Some had usual care; others implemented BFHI type intervention

  17. PROBIT results • Baseline group/usual care • had 6.4% exclusive breastfeeding at 3 months • Intervention hospitals had 43% exclusive breastfeeding rates at 3 months

  18. Did it make a difference to population health? • >17,000 infants enrolled • Decreased infant gastroenteritis • Decreased eczema • Significant increase in school performance, IQ • Even though less than half of all infants were exclusively breastfeed x3 months Kramer et al, Arch Gen Psychiatry. 2008;65(5):578-584 Kramer et al, JAMA, January 24/31, 2001—Vol 285, No. 4

  19. Baby-Friendly makes a difference • Hospital practices affect breastfeeding for months • First Hour is vitally important • Avoiding Supplements is Important • Avoiding pacifiers is important

  20. Why it matters • Patient-Centered Care • Population health • (babies and likely mothers)

  21. Size matters

  22. Other resources • www.massbreastfeeding.org/collaborative • Resource page • Link to videos on Vimeo.org MassBreastfeeding Coalition Password: Skin2Skin www.zipmilk.org

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