Saturday, April 2, 2005
Hall of Mirrors (Hilton Cincinnati Netherland Plaza)
Session: 1219, Poster Session I, 11:00 AM

How to sustain a breastfeeding-friendly environment in only 5 years

Susan Ellerbee, PhD, RN, C, IBCLC, Associate Professor, College of Nursing, University of Oklahoma, 1100 N. Stonewall, Oklahoma City, OK 73117-1297, Rebecca Mannel, BS, IBCLC, Lactation Consultant, Lactation Center, OU Medical Center, N.E. 13th & Lincoln, Oklahoma City, OK 73104-5069, and Sheila Myers, PhD, RN, Clinical Nurse Researcher, Department of Nursing, OU Medical Center, N.E. 13 th & Lincoln, Oklahoma City, OK 73117-1299.

Purpose: To describe current status and perceptions of activities and policies instituted by an academic medical center to implement the Ten Steps of the Baby-Friendly Hospital Initiative (BFHI).

Theoretical/ Conceptual Framework: Evidence-based practice, change theory

Subjects: Nursing & medical administrators, physicians/residents, lactation consultant(s), plus staff nurses for 5-year-follow-up.

Methods: Delaware Valley Hospital Policy Survey (Kovach, 1996) was completed at three points: 1997 (year before major changes), 1999 (one year after initiation of major changes), and 2001 (three years after major changes). Data collection is in progress (2004, five years after major changes). Breastfeeding rates, estimated in 1997, are tracked through a computerized patient data system.

Results: Survey scores indicate a move from “low implementation” in 1997 to “moderately high implementation” in 1999 and 2001. Data for 2004 are not yet available. Breastfeeding initiation rate rose from 30% to approximately 45%. One part-time and five full-time lactation consultants have been hired. The hospital received a BFHI Certificate of Intent in August, 2001. Although some breastfeeding babies still receive artificial baby milk (ABM), syringe, gavage or cup are frequently used. Pacifiers are given only on request. An evidence-based breastfeeding class is part of orientation for new staff, including medical residents. Breastfeeding information is part of mandatory annual education fairs for all staff. A lactation consultant teaches breastfeeding in prenatal classes. An outpatient lactation clinic is open. Data collection for newborns is being expanded to include breastfeeding status at hospital discharge.

Conclusion: Formal policies, education, and support services are in place. BFHI-specific challenges include initiating breastfeeding within the first hour after birth, using artificial baby milk without a medical indication and accepting free supplies of infant formula. Our progress could not be maintained without the staff nurses who remain as the primary advocates for breastfeeding women.

Session #1219 - Poster Session I

The 29th Annual MNRS Research Conference (April 1-4, 2005)