Advancing Excellence in Breastfeeding Support in a Community Hospital

1
Advancing Excellence in Breastfeeding Support in
a Community Hospital

• What does it cost?
• What is the return on investment?

2
What is so hot about FF Thompson?

• Thompson is a community hospital with a Level I
  nursery
• We deliver 650-700 babies a year
• Our breastfeeding initiation rate runs just under
  80, the highest rate in the region for the past
  two years

3
How are we doing post-hospital?

• Survey of 57 moms between 3 and 12 months
  postpartum
• 72 breastfed more than 3 months and planned at
  least 6-12 months
• 28 breastfed less than 3 months, but only two
  breastfed less than 6 weeks

4
Why did moms stop?

• Returned to work
• Put on medication incompatible with nursing
• Stress
• Discomfort
• Severe mastitis
• Pediatrician encouraged supplementation

5
Did they use the Thompson program?

• Of the moms who nursed more than three months,
  75 utilized the support services. Of the 8 moms
  who did not, 4 were multiparas who had
  successfully nursed before.
• Of moms who stopped before three months, only 48
  accessed the support services

6
Yes, we give diaper bags with a powder formula
sample

• But we DONT give formula to babies
• Bag is given at moms request
• Moms who breastfed gt 3 months used the bag but
  not the formula and all said the powder did not
  influence their practice
• Moms who stopped before three months did not use
  the formula until after they had made the
  decision to stop nursing

7
What makes our program comprehensive?

• Prenatal class taught by a lactation specialist
• Commitment by the OB medical staff to encourage
  breastfeeding, and encourage attendance at class.
  Commitment by peds to use consultation before
  supplementation
• Seven certified nurse specialists one Lactation
  Consultant and six Breastfeeding Counselors
• Staff education for consistent, evidence-based
  practice

8
What makes our program comprehensive?

• Lactation consultant has 0.3 FTE dedicated to
  patients
• Nursery hotline and Lactation Consultant
  voicemail
• Consistent follow-up by phone
• Lactation consultations provided postpartum for
  outpatients
• First Time Around group meets monthly
• Parent Review website with special section on
  breastfeeding
• Lactation room available for breastfeeding staff
  to pump at work

9
What does it cost?

• Approximately 1,000 per certification
• Dedicated hours for the Lactation Consultant,
  about 18,000/year
• Instructors for lactation class and First Time
  Around group, about 1,500/year
• Parent Review website, about 4,000/year

10
How do you get organizational support?

• Do it gradually
• Use research to demonstrate the health benefits
  of breastfeeding
• Show results
• Healthy People 2010
• Share the cost among departments

11
Why are we so successful?

• Commitment
• Staff education in evidence-based practice /
  expectation of compliance
• Celebration of success
• Problem solving / knowing the goal
• Give moms the tools and the control

12
Whats in the future?

• Breastfeeding blog
• E-mail surveys for follow-up
• Retail store
• Research