Leveraging Hospital Breastfeeding Data to Improve Maternity Care Practices and Breastfeeding Rates National WIC Association September 11, 2012 Karen Farley, RD, IBCLC California WIC Association 1
Objectives Describe the collaborative process using hospital breastfeeding data to improve hospital breastfeeding policies. Identify 3 strategies for raising public awareness of breastfeeding hospital policies. Illustrate the collaborative impact of maternity care practices in hospitals and WIC. 2
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Mission of Project Bring attention to the gap in any and exclusive breastfeeding rates in hospitals, particularly hospitals with large populations of low-income mothers Produce a statewide grassroots media campaign with the breastfeeding coalitions Multi year strategy using many approaches to advocate for improved exclusive breastfeeding rates by urging hospitals to adopt the California Breastfeeding Model Hospital Policies or Baby Friendly designation 5
Collaboration increased data visibility Newborn screening program of CDPH Epidemiologists in MCAH of CDPH University of CA, Davis, Human Lactation Center California WIC Association Local and State Breastfeeding Coalitions 6
In-Hospital Breastfeeding Data Source: Newborn Screening Form Administered by the CDPH Genetic Disease Screening Program Data collected and placed on CDPH website since late 1990 s Data validated 7
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100 90 80 70 60 50 40 30 20 10 0 Lowest Performing Hospitals Percent Breastfeeding, 2011 Data Any Breastfeeding Exclusive Breastfeeding Breastfeeding Rates 9
Highlighting The Gap Graphically Identified the problem (the gap) while providing tools (policies) to fix the problem 10
County Fact Sheets Using the Data Locally Any versus Exclusive Breastfeeding 11
The Role of Hospital Policies Hospitals that have implemented Baby Friendly or model policies have low supplementation rates Research supports that Baby Friendly status increases exclusive breastfeeding during and after the hospital stay Policies are intended to be implemented as a group, not individually Kramer, JAMA, 2001; Merewood, Pediatrics 2005; UCD Hospital Rpt, 2008 12
Referral to Evidence CDC Guide to Breastfeeding Interventions www.cdc.gov/breastfeeding/pdf/breastfeeding_interventions.pdf Baby Friendly Hospital USA www.babyfriendlyusa.org Providing Breastfeeding Support: Model Hospital Policy Recommendations www.cdph.ca.gov/programs/breastfeeding/documents/mo- 05ModelHospitalPolicyRecommend.pdf The Joint Commission http://www.jointcommission.org/perinatal_care/ The Surgeon General s Call to Action http://www.surgeongeneral.gov/library/calls/breastfeeding/index.html 13
Policies Protect Staff and Patients Problem Insufficient numbers of skilled support staff (time) Policy Solution Policy dictates staff training/ratios Mother s change their minds or demand formula Charting policies can help identify cause, support staff Individual MDs routinely supplement all infants Policy requiring medical need for supplementation Mothers and infants separated Rooming-in/couplet care policies 14
43% of California's babies get breast milk exclusively Advocates, announcing survey results today, say the total should increase because of benefits to mothers and children. By Mary Engel, Los Angeles Times Staff Writer, 2007 The new mother was determined to nurse her son, despite her discomfort after a Cesarean section. But a nurse, without asking, fed the infant formula while he was in the hospital nursery. That was upsetting enough, but then, when given the chance to nurse her baby, the young woman couldn t get her newborn to latch onto her breast. 15
SB 22 (Migden, 2007) Training for hospitals in lowest quartile of breastfeeding rates Model Hospital Policy Toolkit SB 502 (Pavley/deLeon, 2011) Required hospital infant feeding policy to use Baby Friendly guidelines California Laws http://www.calwic.org/storage/ca_breastfeeding_laws. pdf 16
Where to find the data & reports? Report, State and County Facts http://www.calwic.org/focus-areas/breastfeeding/hospital-rates-areports Hospital Breastfeeding Data http://www.cdph.ca.gov/data/statistics/pages/breastfeedingstatis tics.aspx http://www.cdph.ca.gov/data/statistics/pages/inhospitalbreastfe edinginitiationdata.aspx 17
Credit & Contacts For data and slides, thanks to: Dr.Jane Heinig & Jennifer Banuelos, UC Davis Human Lactation Center Daisy Silverio & Kari Malone, California State WIC Public Health Foundation Enterprises WIC Karen Farley CA WIC Association kfarley@calwic.org 530-750-2280 www.calwic.org Dr. Jane Heinig University of California, Davis mjheinig@ucdavis.edu, 530-752-8681 http://lactation.ucdavis.edu/ Robbie Gonzalez-Dow California Breastfeeding Coalition robbie@californiabreastfeeding.org 831-917-8939 www.californiabreastfeeding.org Report funded by the California WIC Association through Kaiser Permanente s Healthy Eating Active Living Program. Photography Credits: William Mercer McLeod & Dina Marie Photography 18