August 16, 2012

Effort seeks to remove breast-feeding barriers

Vanderbilt University has signed on for a statewide project to increase exclusive breast-feeding in hospitals and delivery centers.

Vanderbilt University has signed on for a statewide project to increase exclusive breast-feeding in hospitals and delivery centers.

The Tennessee Initiative for Perinatal Quality Care (TIPQC) kicked off the project recently at Vanderbilt University Medical Center with 16 hospital teams from around the state.

Ashley Childs said it was easy to breast-feed her son, Beau, in Vanderbilt’s NICU because of the presence of a lactation specialist, the proper equipment and the encouragement of the unit’s staff members. (photo by Susan Urmy)

The goal is to improve the health of infants and mothers in Tennessee by removing barriers and providing support for mothers who choose to breast-feed. Participating institutions will track breast-feeding rates and compare to baseline data to measure success. Hospitals and centers around the state have until September to apply to participate in the project.

“By removing hospital barriers and providing better breast-feeding education, we can help more moms meet their breast-feeding goals,” said Anna Morad, M.D., co-director of the Newborn Nursery and assistant professor of Pediatrics. “We will track our breast-feeding rates monthly and try to determine what intervention impacts the rates and, hopefully, increases duration.”

TIPQC, funded by a state Department of Health grant, works to identify opportunities to optimize birth outcomes and implement data-driven provider- and community-based performance improvement initiatives. The organization launched in 2008.

The latest hospital-based project was developed over the past two years and is one of many ongoing efforts for TIPQC that Vanderbilt has been involved in. As of July, about 50 percent of all infants discharged from the newborn nursery were exclusively breast-fed; about 39 percent were fed formula and breastfed; and another 11 percent were strictly formula fed. Vanderbilt hopes to see at least a 10 percent increase in exclusive breast-feeding rates from the project.

“A recent survey of our NICU patients showed that 92 percent had received some breast milk during their stay. This is a noticeable improvement and it is really exciting to see the impact that the TIPQC projects have on our breastfeeding rates,” said Carol Huber, R.N., B.S., the lactation consultant for the NICU.

Studies show that breastfeeding has short-term and long-term impacts for infants, including reduced risks of obesity, diabetes, certain cancers and sudden infant death syndrome.

In January, Vanderbilt took greater steps to encourage breast-feeding. The hospital initiated a new breast-feeding policy that calls for: providers to encourage skin-to-skin contact for mothers and healthy term babies during the first hour after birth; educating mothers of risks of formula-feeding; staff to avoid time limits on breast-feeding; and encouraging rooming-in as a default.

The newborn nursery also no longer provides formula sponsored discharge bags or pacifiers, which can interfere with the success of breast-feeding. Pacifiers can be introduced about three or four weeks after birth once breastfeeding is established. The post-partum unit recently implemented Quiet Time from 2-4 p.m. to give new mothers and babies a break from visitors and non-urgent hospital matters.

In addition, providers and nurses will receive additional training this fall on breast-feeding education.

Vanderbilt continues to work toward earning a Baby-Friendly Hospital designation, part of a global program that encourages and recognizes hospitals and birthing centers that offer an optimal level of care and environment for infant feeding. The hospital should enter stage three soon and is about 10 months into the four-stage process.