Advancing Excellence in Breastfeeding Support in a Community Hospital

1. Advancing Excellence in Breastfeeding Support in a Community Hospital What does it cost? What is the return on investment?

2. What is so hot about FF Thompson? • Thompson is a community hospital with a Level I nursery • We deliver 650-700 babies a year • Our breastfeeding initiation rate runs just under 80%, the highest rate in the region for the past two years

3. How are we doing post-hospital? • Survey of 57 moms between 3 and 12 months postpartum • 72% breastfed more than 3 months and planned at least 6-12 months • 28% breastfed less than 3 months, but only two breastfed less than 6 weeks

4. Why did moms stop? • Returned to work • Put on medication incompatible with nursing • Stress • Discomfort • Severe mastitis • Pediatrician encouraged supplementation

5. Did they use the Thompson program? • Of the moms who nursed more than three months, 75% utilized the support services. Of the 8 moms who did not, 4 were multiparas who had successfully nursed before. • Of moms who stopped before three months, only 48% accessed the support services

6. Yes, we give diaper bags with a powder formula sample • But we DON’T give formula to babies • Bag is given at mom’s request • Moms who breastfed > 3 months used the bag but not the formula and all said the powder did not influence their practice • Moms who stopped before three months did not use the formula until after they had made the decision to stop nursing

7. What makes our program comprehensive? • Prenatal class taught by a lactation specialist • Commitment by the OB medical staff to encourage breastfeeding, and encourage attendance at class. Commitment by peds to use consultation before supplementation • Seven certified nurse specialists: one Lactation Consultant and six Breastfeeding Counselors • Staff education for consistent, evidence-based practice

8. What makes our program comprehensive? • Lactation consultant has 0.3 FTE dedicated to patients • Nursery “hotline” and Lactation Consultant voicemail • Consistent follow-up by phone • Lactation consultations provided postpartum for outpatients • “First Time Around” group meets monthly • Parent Review website with special section on breastfeeding • Lactation room available for breastfeeding staff to pump at work

9. What does it cost? • Approximately $1,000 per certification • Dedicated hours for the Lactation Consultant, about $18,000/year • Instructors for lactation class and First Time Around group, about $1,500/year • Parent Review website, about $4,000/year

10. How do you get organizational support? • Do it gradually • Use research to demonstrate the health benefits of breastfeeding • Show results • Healthy People 2010 • Share the cost among departments

11. Why are we so successful? • Commitment • Staff education in evidence-based practice / expectation of compliance • Celebration of success • Problem solving / knowing the goal • Give moms the tools and the control

12. What’s in the future? • Breastfeeding blog • E-mail surveys for follow-up • Retail store • Research