Breastfeeding, Baby Friendly and Other Fun Stuff

Our hospital is on the journey to Baby-Friendly.  We have been on the journey for the last 4 or so years.  Actually, we have probably been on this journey for longer than that because when I first joined this team as their director, I had a pediatrician who was very excited about  becoming a Baby Friendly Hospital.  We have worked steadily along the way making improvements for mothers and babies.  Our hospital is unique. In fact, it opened it's obstetrical services in the late 80's and was set up as a LDRP unit without a well baby nursery!  Babies and mothers have always roomed-in together!  Pediatricians have always examined babies in the rooms with their mothers.   Unique.  They do not know how unique they are!  Nurses took care of both mothers and babies AND labored mothers too!  All right from the start!

When I first arrived my job was to assist the staff in getting to a place where we were all trained to recover mothers and babies together after cesarean sections.  We had a PACU (Recovery Room) but it was mostly used for a classroom.  Mothers went to the main Recovery Room after cesareans and babies went back to the LDRP room with their dads.  We had the pediatrician who was passionate about Baby Friendly come talk to the staff about how important it was to keep mothers and babies together after cesareans and it was all the staff need to hear.  We were all trained and began to recover moms and babies together.  A few years after that, we did a pilot study called NIMS  (Nursing Intervention to Minimize Maternal and Infant Separation).  We keep mothers and infants visually no more than 10 feet apart after cesareans and we thought we were being progressive because we did cheek to cheek with mothers and babies in the Operating Room and then did skin to skin care in the Recovery Room.  That study was published in JOGNN and we did have some great outcomes!  From there, we learned about the Gentle Cesarean program at Memorial Hospital of Rhode Island and we implemented that at our hospital.  Babies went skin to skin with their mothers in the Operating Room and began to nurse on the Operating Room table very often!  We became known for it in the community!  A good problem to have!  We even were the first hospital in the United States to put triplets skin to skin in the Operating Room and all three of them got a chance to nurse in the OR too!

The Florida Breastfeeding Coalition started their Florida Quest for Quality Maternity Care Award several years ago.  We decided to apply for this award and became the first hospital in the state to achieve the one star award, and then the first in the state to achieve the two star award, and then the first in the state to achieve the three star award and then the first in the state to achieve the four star award.  The fifth star comes when your hospital achieves Baby-Friendly Hospital designation.  (We don't have that one yet, but we will!) Along this pathway, we developed our infant feeding policy, we banned the bags, delayed bathing for newborns, implemented the Golden Hour, Quiet Time, and we continued to work on breastfeeding.  We decided to get all of our nursing staff certified as Breastfeeding Counselors to be able to have a breastfeeding expert at the mother's bedside 24 hours a day, 7 days a week.  This is in addition to our IBCLC who work with our patients.

Last year, we learned about a program called the EMPower Breastfeeding program.  EMPower Breastfeeding: Enhancing Maternity Practices (EMPower) is a hospital-based quality improvement initiative focusing on maternity practices leading to Baby-Friendly designation based on the Ten Steps to Successful Breastfeeding, as defined by the World Health Organization (WHO) and UNICEF. The initiative is funded by the Centers for Disease Control and Prevention’s (CDC) Division of Nutrition, Physical Activity, and Obesity (DNPAO) and is implemented in partnership with the Carolina Global Breastfeeding Institute (CGBI) and Population Health Improvement Partners (PHIP).  We applied to the program and were accepted as one of the 90+ hospitals.  This program allowed us to enter the Baby Friendly USA's 4-D Pathway!  We were so excited!!    So, we continue to learn, grow, change!   It has been great working with the team from EMPower Breastfeeding with our coaches.  We continued on the journey, becoming a Breast Milk Depot for the Mother's Milk Bank of Florida.  We stopped providing pacifiers.  We got rid of all formula company marketing materials.  We talked about safe infant feeding practices to parents.  We started a breastfeeding support group for mothers, partnered with our local WIC office and had peer counselors at our hospital.  We even partnered with our La Leche League group and offered our facility to them to hold meetings!  We also opened a Baby Weigh Station for parents to bring their babies back when ever they wanted to check their baby's weight!

It is hard work but it is the right thing to do for healthy mothers and healthy babies!  It is after all, supporting an Optimal Healing Environment, right from the start of life!