Purpose for the program: This project focused on an innovative collaboration between a metro health department and community hospital to create a free outpatient lactation clinic for breastfeeding support. 

The Louisville Metro Health Department was awarded a 2-year, $7.9 M “Communities Putting Prevention to Work” grant from the Department of Health and Human Services. A multi-strategy community approach, the project focused on policy, environmental and systems changes to address risk factors for obesity by improving access to healthy foods and increasing access to physical activity. Breastfeeding is the first step in accessing healthy nutrition to prevent obesity and other chronic diseases. The grant provided salary dollars for the IBCLC staff; In-kind donations of space, supplies, office materials and staff benefits were provided by the hospital. Baptist Hospital East was the first hospital in the area to develop the clinic and will continue the service after the grant due to the need and satisfaction expressed by participants.

Proposed change:  To enhance infant nutrition goals by increasing breastfeeding support and continuation to six months post delivery.

Implementation, outcomes and evaluation:

Setting:

Baptist Hospital East, a 511-bed community hospital had 3,026 deliveries and was responsible for 22.9% of all deliveries to Louisville area between January and December 2010. Our goal is to “promote, support, and protect” the breastfeeding relationship across the continuum of pregnancy and the post partum period. Prenatal breastfeeding education is currently provided, and breastfeeding inpatients receive support from five IBCLCs, 7 days/week; the addition of an outpatient clinic allows an additional layer of patient support.  

Participants:

Any breastfeeding metro resident delivered at any metro area hospital.

July-October 2010

- Explored space needs, FTE to meet staffing, in-kind donations

October 2010

-Location set; office retro-fitted

-Charge structure to bill grant developed

-Assessment/documentation forms created

November 2010

-“Open for Business,” November 26, 2010

-Marketing to OB, Peds offices

December- January 2011

-Created promotional materials

-Publicized to service area residents

January 2011-March 2012

- Developed sustainability plan

Mid-grant, 258 women have received lactation support in the clinic. The majority are self-referred, and report high patient satisfaction for the service received. Outcomes data at the end of the grant period will determine the impact of the clinic on supporting the breastfeeding relationship. A sustainability plan has been developed to continue the service post grant period due to its value-added benefit to patients.

Implications for nursing practice: Partnering between community agencies can lead to mutually beneficial outcomes.

Keywords: Breastfeeding, Obesity Prevention, Lactation Support