1. Every Week Counts Learning Collaborative July 13, 2012

2. Preparing for a Lifetime, It’s Everyone’s Responsibility
Breastfeeding Workgroup

3. Breastfeeding Workgroup Co-Leads
Nancy Bacon, MS, RD/LD, CDE MCH Nutrition Consultant Maternal and Child Health Service Oklahoma State Department of Health Adrianna Halstead, RD/LD WIC Breastfeeding Peer Counseling Specialist WIC Service Oklahoma State Department of Health or
Will add brief info here re the workgroup history

4. Breastfeeding Workgroup Purpose
Increase the % of mothers who breastfeed their infants at 6 months of age.
Outline specific breastfeeding activities that will improve maternal & infant outcomes.
Coordinate with WIC to plan and promote the annual WIC Breastfeeding Conference.
Provide consistent breastfeeding messages.

5. Breastfeeding Workgroup Purpose
Maintain the Breastfeeding Website
Support the OK Breastfeeding Hotline
MILK (6455)
Support the OK Hospital Breastfeeding Education Project
Increase the number of Baby-Friendly hospitals in Oklahoma

6. Oklahoma Hospital Breastfeeding Education Project Leader
Rebecca “Becky” Mannel, BS, IBCLC, FILCA Clinical Instructor Department of OB/GYN University of Oklahoma Health Sciences Center
Since 2008, the OSDH has partnered with the OUHSC Dept of OB/GYN to provide a statewide breastfeeding hotline for nursing mothers and families, expectant parents, and health care providers ( MILK (6455). In Oct of 2010, this partnership was expanded to create Oklahoma’s Hospital Breastfeeding Education Project. This project provides birthing facilities in Okla. assistance to help assess their current level of breastfeeding care and identify areas to improve. Becky Mannel, Lactation Services Manager and Clinical Instructor with OUHSC’s Dept. of OB/GYN, is the project coordinator. She offers in-person evidence-based staff trainings, individual train the trainer sessions, ongoing technical support, and additional staff education and resources as needed. Since the project’s launch, 42 of our 59 delivering hospitals are participating .

7. Surgeon General’s Call to Action: Health Care System
Ensure that maternity care practices around the United States are fully supportive of breastfeeding.
Provide education and training in breastfeeding for all health professionals who care for women and children.

8. CDC’s Breastfeeding “Report Card”
Maternity Practices & Infant Nutrition/Care (mPINC) Survey 2009
US Average: 65 out of 100
Oklahoma score: 55
Staff breastfeeding education:
51 out of 100
Oklahoma score: 38
These are failing grades!
How did your hospital score?

9. New Breastfeeding Goals from Healthy People 2020
Objective
U.S. Baseline
HP 2020 Goal
Worksite Lactation Support Programs
25% of employers
38% of employers
Reduce Formula Supplementation in 1st 2 days of life
24.2% of breastfed newborns
14.2% of breastfed newborns
Increase # of Baby-Friendly Hospitals
4% of U.S. hospitals
8.1% of US hospitals

10. Oklahoma Hospital Breastfeeding Education Project
Purpose
Increase breastfeeding initiation and duration rates through change in breastfeeding related maternity care policies and practices in Oklahoma hospitals

11. Activities to Date Contract approved Oct 2010
CDC “ARRA” funding
Title V funding
Ongoing curriculum review/development
Data collection and collaboration
Office of Perinatal Quality Improvement
OK Hospital Association
Rising Star Education’s Breastfeeding Continuing Education Program (BCEP)

12. Activities to Date Initial phase launched in Dec 2010
13 Site visits conducted
42 participating birthing hospitals
7 BCEP trainer sessions provided
520 BCEP books provided to 42 hospitals
Full day staff training class provided statewide
Website developed
Resources – modules, videos, policies
Recognition for hospitals
– For Hospitals
8 of 20 hospitals responded initially

13. Hospital Stories “We put our formula in the supply pyxis”
Implementing skin to skin in first hour
“most of our nurses did this at previous jobs!”
“We have changed our HR policy so our staff can use break times for milk expression”
“We have provided BCEP to ALL our staff and our doctors”
We have decided to pursue Baby-Friendly!”

14. Baby-Friendly Oklahoma
Purpose:
Provide OK Birthing hospitals support to work toward Baby-Friendly Hospital designation
Offer a statewide Baby-Friendly Hospital Summit (winter 2013) to educate maternity care leaders and promote steps toward the Baby-Friendly designation
Goals:
Improve exclusive breastfeeding rates at hospital discharge
Improve duration rates
Reduce Oklahoma infant mortality and child/adult obesity rates

15. Baby-Friendly Hospital = Optimal Breastfeeding Care
Two main components:
Ten Steps to Successful Breastfeeding
No marketing of breastmilk substitutes in the hospital
Baby-Friendly hospitals do not accept or distribute free or low-cost supplies of breastmilk substitutes, nipples or pacifiers.
We’re also working to increase the number of baby-friendly certified hospitals in OK, and have received funding to continue these efforts. We’re currently working to identify 10 birthing hospitals that will to work toward achieving the Baby-Friendly Hospital designation by beginning implementing 4 of the 10 Steps to Successful Breastfeeding

16. Ten Steps to Successful Breastfeeding
Every facility providing maternity services and care for newborn infants should:
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 if they should be separated from their infants.

17. Ten Steps to Successful Breastfeeding
Give newborn infants no food or drink other than breastmilk, unless medically indicated.
Practice rooming-in – allow mothers and infants to remain together – 24 hours a day.
Encourage breastfeeding on demand.
Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

19. Baby-Friendly Oklahoma July 2012 – June 2013
Year One - Recruit first group of 10 hospitals
Hospitals will:
Sign a commitment letter to implement 4 of the 10 Steps in 1st year
Participate in kickoff conference call/webinar
Complete Baby-Friendly USA Discovery phase (1st 2 months)
Register, CEO support letter, self-assessment
Begin Baby-Friendly USA Development phase
Policy, staff training, patient education
Baby-Friendly Oklahoma provides:
Website Resources
Model Policy
Baby-Friendly Curriculum (15 nursing contact hours)
Regional Train the trainer skills labs (verify competency)
Regularly scheduled conference calls for hospital teams
Complete Baby-Friendly USA Discovery phase (1st 2 months)

20. Baby-Friendly Oklahoma (Year 1)
Hospital Maternity Leadership Summit – Winter 2013
Nationally known speakers
Hospitals invited to send a MCH Leadership team (up to 3) to learn ways to implement the 10 Steps
Participating Hospitals receive:
$500 travel reimbursement for team attending Summit
$3,000 stipend for part of Baby-Friendly Fees
Ongoing support, resources, and breastfeeding education for all healthcare staff to promote adoption of evidence- based breastfeeding policies
On site and regional trainings, and regularly scheduled
conference calls

21. Baby-Friendly Hospital Initiative (Year 2 ) July 2013- June 2014
Recruit second group of 10 hospitals
Repeat first year steps
First group of 10 hospitals to complete Development and Dissemination phases
Collect data and address gaps in implementation of 10 steps
Baby-Friendly Oklahoma
Provides team for mock surveys
Calculates fair market value of formula/supplies purchasing for hospitals

22. Baby-Friendly Hospital Initiative (Year 3 ) July 2013 - July 2014
1st group of hospitals will complete Designation Phase
Schedule readiness telephone interview with Baby-Friendly USA
Conduct mock surveys with OK Baby-Friendly team
Schedule Baby-Friendly USA assessment
Recruit third group of 10 hospitals
Repeat first and second year steps

23. Oklahoma Hospitals Doing the Right Thing
Join your peers in eliminating the negative practice of giving commercial formula “gift” bags to new families!
Bag-Free
Going Bag-Free
Interested
Great Plains Regional
Claremore Indian
Duncan Regional
Jackson County Memorial
Deaconess
Hillcrest Medical Center
OU Medical Center, OKC
ALL Integris Hospitals
Mercy Health Center
OU Medical Center, Edmond
Mercy Memorial
Norman Regional Healthplex system
Weatherford Regional
OSU Medical Center
St. John’s
St Anthony’s
Unity Health Center

24. Oklahoma Hospitals Doing the Right Thing
To join the effort, contact Becky Mannel or OPQI office
Goal: Bag free in August for US Breastfeeding Month/World Breastfeeding Week
Get your hospital included in the press release which is sure to generate national attention!
Hospitals should market health,
and nothing else!