Baby Friendly Hospital Initiative

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Making a Difference in the Communities We Serve by Improving Infant Feeding

The Spectrum Health department of Women’s and Infant Services serves about 15,000 mothers and babies every year. We recognize that our department can make a significant impact on the health of the community we serve by promoting, protecting and improving breastfeeding success in our patient population.

Breastfeeding is one of the most effective preventive health measures for infants and mothers. Studies show that breastfeeding is associated with reduced ear infection, gastroenteritis, severe lower respiratory tract infections, atopic dermatitis, asthma, obesity, Type I and Type II diabetes, childhood leukemia, SIDS and necrotizing entercolitis.

The most recent Centers for Disease Control and Prevention (CDC) data show that 3 out of every 4 mothers in the United States start out breastfeeding. However, rates of breastfeeding at 6-12 months remain low compared to other developed countries worldwide. 48% of newborns that start out breastfeeding will receive formula before 48 hours of age.

Hospital policies and healthcare workers’ support of breastfeeding women during their hospital stay are important factors in their success. (Kuan, 1999) To address the most disruptive hospital practices to breastfeeding and mother-infant bonding, the World Health Organization identified Ten Steps to Successful Breastfeeding. Baby-Friendly USA was established to promote optimal infant feeding care by providing specialty designation to hospitals that demonstrate excellence in these Ten Steps.

In 2011, approximately 78% of SH WIS patients intended to breastfeed, 50% of those postpartum patients exclusively breastfed.

breast-feeding-graphbf-rate-graphexclusive-breastfeeding-graph

Breastfeeding rates did not meet the national standard and there was a 28% gap between patients that intended to breastfeed and those that were successful in exclusively breastfeeding.

In July 2012, Spectrum Health Women’s and Infant Services leaders, with executive, nursing and physician support, endorsed the 10 Steps to Successful Breastfeeding as outlined by Baby Friendly USA as best practice.  Plans for successful implementation of the 10 Steps were launched in January 2013 and a new model of care that promoted mother-infant bonding, supported the mother’s infant feeding choice and eliminated barriers to successful breastfeeding was fully implemented by June 2013.

Practice changes modeling the 10 Steps included:

  • Infant-led Feeding – Scheduled infant feeding times were eliminated and no restrictions were placed on breastfeeding frequency or duration as mothers learned to recognize feeding cues.
  • Pacifiers – Nursing care supported the American Academy of Pediatrics recommendation that pacifiers not be routinely used until breastfeeding is well established at approximately 3-4 weeks of age.
  • Patient-Led Rest Time – To advocate for patient’s rest a Patient-Led Rest Time was implemented.  At a time determined by the patient no staff, physicians or visitors could enter their room for a 1-2 hour period except for emergent situations to allow for rest and bonding time.  
  • Rooming-In – Rooming-In 24 hours a day became the standard for mothers and healthy newborns.  Doctors and nurses stopped routinely removing the baby from the room and started providing newborn care at the mother’s bedside.  Mother-baby separation occurred only at the mother’s request.
  • Newborn Observation Area – The normal newborn nursery got a new name!  The Newborn Observation Area provided space for medical procedures (such as circumcisions) and surveillance for infants that needed additional assessment and care.
  • Exclusive Breastmilk Feeding – Breastmilk feeding became the optimal feeding choice for newborns and was reinforced by staff supporting breastfeeding mothers and the expression of breastmilk as the first choice for supplementation. Formula supplementation was only used for medical indication or at a mother’s request.

At approximately 16 months post implementation of the new model of care, exclusive breastfeeding rates have increased from 50% to an average of 70%. Also, greater than 90% of mothers choose to exclusively breastfeed- that’s a 12% increase and a testament to the robust prenatal breastfeeding education curriculum implanted as Baby Friendly Step 3. The gap between patients who choose to breastfeed and those that exclusively breastfeed is 8% lower.

Each year exclusive breastfeeding rates have improved.

In 2014 our goal is to be evaluated by Baby Friendly USA on our success in implementing the 10 Steps to Successful Breastfeeding.  If we meet the criteria, Spectrum Health will be awarded the Baby Friendly Designation, an honor only 7% of US hospitals have received.  This year we will also work hard to sustain the practice changes and increase our breastfeeding rates.

 

Team Members:

Susan Denison AA, LCPC, IBCLC
Laurel Jander RN BSN NE-BC
Erin Keenan RN, BSN
Charmaine Kyle MSN, RN, C-EFM
Katherine McNabnay BSN, RN, CBC
Rosalie Glowney BSN, RN, MSHLP, CPHRM, NE-BC
Janet Nelson MSN, RN, C-OB, C-EFM
Christina Pries MSN, RN, CNOR
Joan Rikli MSN, RN, CPNP, NE-BC
Jilaine Snoeyink BS
Sharon Strek MSN-Ed, RNC-OB
Bev Vanderwal MN, RNC-OB, C-EFM
Becky Vanlaan MSA, MSN, RNC-OB
Stacy Vining BSN, RN

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