1. Baby Friendly USA 4D Pathway
DISCOVERY (July 2012)
CEO Letter of Support
Application
Self Appraisal Tool
NICHQ Best Fed Beginnings
DEVELOPMENT (Oct 2012)
Infant Feeding & Related Policies
Staff /Provider Training Curriculum
Patient Teaching Plans
Data Collection Plan
Baby Friendly R Designation
July
2015
This the pathway to achieving baby friendly. We are currently in the dissemination phase with the goal of achieving Baby Friendly designation in September 2014.
DISSEMINATION (Feb 2013)
Staff /Provider Training
Collect Data :
Chart Audits
Patient Interviews
QI Plan
DESIGNATION (Mar 2014)
Implement QI Plan
Readiness Interview
On Site Assessment (May 2015)

2. Chart/Patient Interviews
Tracking Our Progress
Step
Where We Start
July 2012
April – May
2015
Chart/Patient Interviews
Patient Interviews
3. Prenatal Education
Breastfeeding discussed
Benefits discussed
Patient knows 2 health benefits
Patient knows 2 of 5 topics
43%
29%
14%
100%
90%
50%
4. Skin to Skin: vaginal birth
cesarean birth
38%
40%
5. Mother assisted to:
Breastfeed (MBU)
Express < 6 hrs ( NICU )
42%
92%
83%
6. Fed breastmilk only
Educated on supplementing
Taught safe formula prep & feeding
28%
67%
No data
62%
75%
7. Rooming In
93%
8. Feed on Cue
No clock times advised
32%
30%
9. No bottle nipple
No pacifier
Home pacifier + Educated
56%
44%
20%
77%
10. Referred to post d/c breastfeeding
support

3. Step
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar
2015
3. Prenatal Ed
Brstfd discussed
Benefits discussed
Mom knows 2 benefits
Mom knows 2/5 topics
90%
60%
20%
30%
100%
70%
44%
67%
92%
42%
45%
91%
37%
64%
4. Skin to Skin
Vaginal
C/Section
78%
71%
83%
100 %
5. Assist to breastfeed
W/in 6hrs
Shown pos./latch
Mom can pos/latch
Hand expression
Express < 6hrs ( NICU baby)
49%
80%
69%
84%
73%
85%
75%
6. Exclusive Breastfeeding
Supplement w/Ed
Taught safe formula prep/feeding 3%
40%
50% 0%
61%
54%
7. Rooming In
8. Feed On Cue
Hourly intervals
86% 7%
93%
53%
57%
31%
87%
27%
9. No bottle nipples
No pacifier
Home paci w/Ed
79%
82%
62%
46%
25%
0**
10. Post D/C Help
** 7 out of 12 breastfeeding babies used pacifiers from home, None of these mothers reported receiving education of impact of pacifier on breastfeeding.

4. Where Do We Stand? March 16, 2015 Past 12 months Step >80% < 80%
<80%
1. Policies
complete
2.Training
3. Prenatal Ed
12 months 
4. Skin to Skin: c/section
vaginal
 c/sec
11 months
8 months
1 month
4 months
5. Help Breastfeed (MBU)
Express < 6 hrs ( NICU)
3 months
 7 months
6. Breastmilk only
Educate re: supplement
11months
7. Rooming In
6 months
8. Feed on Cue
No clock times 
10 months
2 months
 8 months
9. Avoid artificial nipple
Avoid pacifier
10.Source of post d/c support

5. Meeting & Exceeding our 80% Goal:
Patient Interviews
STEP5: Assist With Breastfeeding: Medical Separation

6. Meeting our 80% Goal: Patient Interviews
STEP 5: Safe Formula Preparation

7. Approaching the 80% Goal Patient Interviews
STEP4:Skin to Skin: Cesarean Section

8. Steps with Vulnerabilities
Patient Interviews
STEP4:Skin to Skin : Vaginal Birth

9. Steps with Vulnerabilities
Patient Interviews
STEP5: Assist With Breastfeeding: Stable Dyads

10. Steps with Vulnerabilities
STEP 6: Exclusive Breastfeeding

11. Steps with Vulnerabilities
Patient Interviews
STEP 7: Rooming In

12. Steps with Vulnerabilities
Patient Interviews
STEP 8: Feed on Cue

13. Steps with Vulnerabilities
Patient Interviews
STEP 9: No artificial nipples or pacifiers

14. Steps with Vulnerabilities
Patient Interviews
STEP 10: Post Discharge Breastfeeding Support

15. Opportunities for Improvement…
Patient Interviews
STEP 3: Prenatal Education