Keeping It Together –Implementing Best Fed Beginningsa Collaborative Approach For a Large Urban Teaching Hospital's Journey To Baby Friendly Designation

Purpose for the program:

This presentation will chronicle the journey of a large volume, urban, teaching hospital’s experiences through the Best Fed Beginnings Collaborative on the road to Baby Friendly Designation. Best Fed Beginnings is a National NICHQ Collaborative to promote breastfeeding education in hospitals. Our hospital is one of 90 hospitals chosen nationwide to participate in this collaborative as a pathway to Baby Friendly Designation.

Breastfeeding initiation rates, exclusivity rates, and sustaining for one year rates are all much lower in the United States than is desired by Healthy People or AAP. Breastfeeding is recognized as the best choice for infant feeding. Healthy People 2020 goals include increasing the proportion of infants who are breastfed at all and those exclusively breastfed at 3, 6 months and 1 year.

Proposed change:

Our goal is to provide the hospital staff, physicians and patients the education and support to allow for the greatest success rates for mother’s breastfeeding their infants.  Evidence shows the care provided in the hospital during and after delivery directly impact the success rates for breastfeeding of an infant.  We worked to change our delivery of care model for the mother and infant to remain together, support mother/ family education, and provide family centered care in our facility.

Implementation, outcomes and evaluation:

Our facility started in 2011 towards the goal of becoming Baby Friendly by reviewing our current practices and determining the route to take.  We evaluated our practices, and decided to apply to the Best Fed Beginnings Initiative.  Our challenges included traditional roles, none of which were focused on helping support the success of breastfeeding. We removed the formula bags and pacifiers; initiated skin to skin time, and a Newborn Admission nurse in the delivery suite. We discovered major hurdles regarding nurse/physician comfort levels, “perceptions” of what patients wanted; and what was “best” for mother/baby.

We have a multidisciplinary team including obstetricians, pediatricians, nursing staff, leadership, and lactation; together we have made great progress towards our goal for a Baby Friendly Designation survey by September 2014.

Implications for nursing practice:

Our path towards Baby Friendly Designation has improved patient satisfaction, nursing satisfaction and empowered new mothers/ families to make informed choices for the health of the infant and mother. We hope to have our Baby Friendly Survey in fall of 2014.  This change has empowered nursing and physicians to work together for a common goal.

Keywords: Baby Friendly, Breastfeeding