a call to action: improving breastfeeding initiation and duration in the hudson valley
TRANSCRIPT
A Call to Action:
Improving Breastfeeding Initiation and
Duration in the Hudson Valley
Maternal-Infant Services Network www.misn-ny.org
Stephanie Sosnowski
Deputy Director, Maternal-Infant Services Network
Chair, New York Statewide Breastfeeding Coalition
Disclosure: I have no actual or potential declarations to make in relation to this program
Maternal-Infant Services Network www.misn-ny.org
Objectives
• Describe NYS DOH Breastfeeding Promotion Initiatives
• Describe how to increase breastfeeding in the Hudson Valley, including cesarean birth mothers
Maternal-Infant Services Network www.misn-ny.org
Breastfeeding: A National Public Health Priority
CDC 2007 National survey:
MPINC
Maternity Practices in Infant Nutrition and Care
Maternal-Infant Services Network www.misn-ny.org
2007 Breastfeeding Rates (%)
0102030405060708090
Ever BF 6 mos. 12 mos. Exclusive at3 mos.
Exclusive at6 mos
NYS
National
HP 2010
Source: CDC, NIS, provisional data, 2007 births
Maternal-Infant Services Network www.misn-ny.org
Exclusive Breastfeeding
• As defined by Joint Commission National Quality Core Measures
www.manual.jointcommission.org/releases/TJC2010A/DataEleme0273.html
“Newborn receiving only breast milk and no other liquids or solids except for drops or syrups
consisting of vitamins, minerals, or medicines.”
Maternal-Infant Services Network www.misn-ny.org
Breastfeeding, by Race, NYS
0
10
20
30
40
50
60
70
80
2001
2002
2003
2004
2005
2006
2007
2008
White, not Hispanic
Black, not Hispanic
Maternal-Infant Services Network www.misn-ny.org
2008 % BF, by race
0102030405060708090
Wh
ite,
His
pa
nic
Asi
an
/Pa
cific
Isla
nd
er
% ever Bf
6 mos.
12 mos
Source: NYS PedNSS, 2010
Bla
ck
Am
. In
dia
n/A
lask
an
Mu
ltip
le
race
s
Maternal-Infant Services Network www.misn-ny.org
Hudson ValleyNYS 2008 PedNSS Breastfeeding %
0102030405060708090
100
Dutches
s
Orang
e
Putna
m
Rocklan
d
Sulliva
n
Ulster
Westc
heste
r
Ever BF
6 mos.
12 mos.
3 mos.
6 mos
Source: NYS DOH 2008 Pediatric Nutrition Surveillance
Maternal-Infant Services Network www.misn-ny.org
2009 Breastfeeding Rates by Hospital (county averages)
0102030405060708090
100
Dutches
s Coun
ty
Orang
e Coun
ty
Rocklan
d Coun
ty
Ulster C
ounty
Westc
heste
r Coun
ty
HV ave
rage (
7 co
unties)
Fed any BM
Exclusive BM
BM supplemented withformula
Source: NYS DOH Maternity Information Leaflet
Maternal-Infant Services Network www.misn-ny.org
2009 NYSDOH Call to Action
• Provide information on website and in Maternity Information leaflet about infant feeding practices at each hospital
• Increase visibility of individual hospital performance measures related to initiation and exclusivity.
Maternal-Infant Services Network www.misn-ny.org
NYSDOH Call to Action, cont.
• Called on healthcare providers to:
-Talk with prenatal patients and new moms
-Refer women to appropriate resources; to WIC if eligible
Maternal-Infant Services Network www.misn-ny.org
Call to Action, cont.
Called on maternity services hospitals to:• Review hospital policies to ensure they are in
compliance with NYS Perinatal Regulations.• Provide staff training, designate staff to attend
NYSDOH training opportunities.• Review hospital policies to ensure that formula is
only provided to breastfed infants when medically indicated, and that educational material provided to mothers is free of commercial interest.
NYSDOH Breastfeeding Publications
Breastfeeding Your Baby - Simply the Best Brochure, English: #2961
Breastfeeding Your Baby - Simply the Best Brochure, Spanish: #2962
Breastfeeding - Simply the Best, Pocket Guide for Health Care Providers: #2963
Mail, E-mail or Fax Orders (limit 200) to:
NYSDOH Distribution Center 21 Simmons Lane Albany, NY 12204
E-mail: [email protected]: 518-465-0432
Maternal-Infant Services Network www.misn-ny.org
Breastfeeding…For My Baby…
For Me Campaign • http://www.youtube.com/watch?v=
qjoWWUYDKQM
• http://www.youtube.com/watch?v=Vyxh8RnuK3U
• http://www.youtube.com/watch?v=OclFqV1hb14
Breastfeeding and Cesareans
Source:
Percentage of mothers who had a cesarean delivery without complications who began to breastfeed in the recovery room by perinatal designation.
17
Percentage of mothers who had a vaginal delivery without complications who began to breastfeed in the delivery room by perinatal designation.
NYS DOH 2009 Hospital Survey
Maternal-Infant Services Network www.misn-ny.org
Breastfeeding Committee Recommendations
• Baby Friendly®
www.babyfriendlyusa.org
• Academy of Breastfeeding Medicine Clinical Protocol #7: Model Breastfeeding Policy (Revision 2010)www.bfmed.org
Maternal-Infant Services Network www.misn-ny.org
Breastfeeding - Just 10 Steps! The Baby-Friendly® Way
•Have a written breastfeeding policy that is routinely communicated to all health care staff
•Train all health care staff in skills necessary to implement this policy
•Inform all pregnant women about the benefits and management of breastfeeding
•Help mothers initiate breastfeeding within one hour of birth
•Show mothers how to breastfeed, and how to maintain lactation even they should be separated from their infants.
Maternal-Infant Services Network www.misn-ny.org
10 Steps, cont.
•Practice rooming in - allowing mothers and infants to remain together - 24 hours a day.
•Encourage breastfeeding on demand.
•Give newborn infants no food or drink other than breastmilk unless medically indicated.
•Give no artificial teats or pacifiers to breastfeeding infants
•Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.
Maternal-Infant Services Network www.misn-ny.org
ABM Policy #7 (rev. 2010)
Best Practices for Breastfeeding Support Following Cesarean Delivery
1. Early mother-infant contact. Avoidance of separation unless dictated by medical indications
2. Early breastfeeding <1 hour after delivery. Can occur in delivery suite or recovery room.
3. Regional anesthesia for cesarean delivery.
4. Infant Positioning to minimize incision discomfort. Use of side-lying, football breastfeeding position. Use of pillow to protect incision site.
5. Use of regional medication after cord clamping to decrease the need for postoperative narcotics.
ABM Policy #7 (rev. 2010)
Best Practices for Breastfeeding Support Following Cesarean Delivery, cont.
6. Preferential use of narcotics with less adverse effects on neonatal behavior
7. Frequent breastfeeding and rooming-in such as would be routine for vaginal delivery.
8. Protocols for early breast pumping and expression if infant separation is dictated because of medical indication such as prematurity. Should be initiated day of delivery.
9. Easy availability of lactation expert for further support and assistance if needed.
10. Monitoring for delayed onset of lactation in mother and excessive weight loss in the newborn.
11. Education and encouragement of family members in methods of supporting breastfeeding in the new family.
Maternal-Infant Services Network www.misn-ny.org
Thank you
• “We need to direct even more effort toward making sure mothers have the support they need in hospitals, workplaces and communities to continue breastfeeding beyond the first few days of life, so they can make it to those 6 and 12 month marks.”
William Dietz, MD, PhD, Director of CDC’s Division of Nutrition, Physical Activity and Obesity.
Maternal-Infant Services Network www.misn-ny.org
Next meeting
Thursday, December 2, 2010
9 am – Hudson Valley Hospital Center
Educational Offering: Implementing the Joint Commission Perinatal Care Core Measure on
Exclusive Breastfeeding
For more information: