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Improving Hospital Breastfeeding Success Rates

Improving Hospital Breastfeeding Success Rates. compiled & presented by: Cinny Kittle, MS Project Director ckittle@wvha.org Christine Compton, BA, CLS Project Coordinator ctcompton@frontier.com. The WV Breastfeeding Alliance. www.wvbfa.com Our Mission:

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Improving Hospital Breastfeeding Success Rates

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  1. Improving Hospital Breastfeeding Success Rates

  2. compiled & presented by: Cinny Kittle, MS Project Director ckittle@wvha.org Christine Compton, BA, CLS Project Coordinator ctcompton@frontier.com

  3. The WV Breastfeeding Alliance www.wvbfa.com Our Mission: To improve the health of West Virginians by working collaboratively to protect, promote, and educate our community about breastfeeding. WV’s Perinatal Partnership The West Virginia Hospital Association The Healthcare Education Foundation of West Virginia

  4. Importance of Breastfeeding

  5. Health Implications for Babies NOT breastfeeding increases risk of: Obesity Ear infections Respiratory infections Gastrointestinal infections Skin conditions Type 1 and Type 2 diabetes Leukemia Sudden Infant Death Syndrome (AHRQ 2007) Also breastfed babies enjoy an enhanced vaccine immune response

  6. Health Implication for Mothers Mothers who breastfeed are at a lower risk of: Premenopausal breast cancer Ovarian cancer Type 2 diabetes (AHRQ 2007) Breastfeeding mothers: Recover from pregnancy faster Enjoy a delayed menses Healthier people are happier & more productive

  7. The State of Breastfeeding

  8. WV vs. US Breastfeeding Rates Ever Breastfeed 53.0% 75.0% Breastfeeding at 6 months 25.9% 43.0% Breastfeeding at 12 months 12.5% 22.4% Exclusively breastfeeding at 3 months 18.3% 33.0% Exclusively breastfeeding at 6 months 7.0% 13.3% Source: Centers for Disease Control and Prevention, Breastfeeding Report Card, 2007 Births; 2010 report

  9. Breastfeeding is not seen as the social norm Cultural and societal barriers and biases exist Lack of policies & practices to support breastfeeding in workplaces and in the medical community Why WV rates are low

  10. The Office - The Delivery episode Video clip

  11. Nationwide survey administered by the CDC in 2007 All hospitals (3,143) and birth centers (138) in US were invited to participate. To be completed by person most knowledgeable about the issues. 84% of the 32 eligible hospitals and birth centers in WV responded Each of those received their facility-specific benchmarks in October 2008. Maternity Care Practices in Infant Nutrition and Care : mPINC

  12. Dimensions of Care in the mPINC Survey •Initial skin-to-skin contact •Initial breastfeeding opportunity • Routine procedures performed skin-to-skin Labor & Delivery 53

  13. Dimensions of Care in the mPINC Survey Feeding of Breastfed Infants* Initial feeding received after birth Supplementary feedings Breastfeeding Assistance** Documentation of feeding decision Breastfeeding advice and counseling Assessment and observation of breastfeeding Pacifier use Contact Between Mother and Infant***Separation of mother and newborn during transition to receiving patient care units Patient rooming-in Instances of mother infant separation throughout the intrapartum stay Postpartum Care 71* 76** 58***

  14. Dimensions of Care in the mPINC Survey Assurance of ambulatory breastfeeding support Distribution of “discharge packs” containing infant formula Facility Discharge Care 25

  15. Dimensions of Care in the mPINC Survey Preparation of new staff Continuing education Competency assessment Staff Training 44

  16. Dimensions of Care in the mPINC Survey Breastfeeding policy Communication of breastfeeding policy Infant feeding documentation policy Employee breastfeeding support Facility receipt of free infant formula Prenatal Breastfeeding instruction Coordination of lactation care Structural & Organizational Aspects of Care Delivery 58

  17. Summary Plans underway to conduct the survey again in 2011 May become biannual WV mPINC Score 55

  18. Improvement is NeededCDC suggestions: Examine WV regulations for maternity facilities, evaluate their evidence base, revise if necessary WV code?

  19. Improvement is NeededCDC suggestions (cont.): Sponsor statewide summit of key decision-making staff at maternity facilities to highlight the importance of evidence-based practices for breastfeeding Symposium June 2010

  20. Outcomes of Symposium All parties were presented with update of status of breastfeeding issues in WV Identification of key players in breastfeeding issues, and challenges/barriers met by them, along with suggested solutions Set the stage for continued collaboration on addressing breastfeeding issues in the state Hospitals received detailed information about The Joint Commission Perinatal Care Core Measure Set

  21. Improvement is NeededCDC suggestions (cont.): Pay for hospital staff to participate in 18-hour training course in breastfeeding CLS Trainings Nov.‘08; May’09;Dec.’10 Road Show in development

  22. Improvement is NeededCDC suggestions (cont.): Establish links among maternity facilities and community breastfeeding support networks in WV WVBA WV Perinatal Partnership

  23. Improvement is NeededCDC suggestions (cont.): Identify and implement successful programs within hospital settings Choose a significant wide-spread practice and adjust it to be evidence-based and supportive of breastfeeding, (i.e. all routine procedures are preformed in mother’s room or while infant is skin-to-skin)

  24. Changes in maternity care practices improve breastfeeding rates 2006 National Immunization Survey 7 had the lowest percentages of children breastfed for 6 months (less than 30%) Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma and West Virginia Same 7 states with the lowest mPINC scores (48-58)

  25. The Ten Steps To Successful Breastfeeding Baby-Friendly Hospital Initiative 1 - Have a written breastfeeding policy that is routinely communicated to all health care staff. 2 - Train all health care staff in skills necessary to implement this policy. 3 - Inform all pregnant women about the benefits and management of breastfeeding. 4 - Help mothers initiate breastfeeding within one hour of birth. 5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. 6 - Give newborn infants no food or drink other than breast milk, unless medically indicated. 7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day. 8 - Encourage breastfeeding on demand. 9 - Give no pacifiers or artificial nipples to breastfeeding infants. 10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

  26. 5 Breastfeeding Supportivehospital practices: Initiate breastfeeding 1st hour after delivery Avoid other fluids & solids unless medically necessary Promote 24-hour Rooming-in No bottles or pacifiers while infant is in hospital Share phone #’s for moms to call for help after discharge

  27. The Key to Success = POLICY

  28. It is a matter of public health. Breastfeeding is not just a lifestyle choice.

  29. Questions & Discussion www.wvbfa.com THANK YOU! WV Perinatal Partnership

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