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Baby Steps for Breastfeeding Success
Communities Putting Prevention to Work
Arizona Champions for Change
"Arizona Baby Steps to Breastfeeding Success" Maternity Care Practices Initiative
Five Steps to improve Breastfeeding Duration in Arizona
Making institutional changes in maternity care practices has been shown to significantly increase breastfeeding initiation and duration rates. While the Ten Steps to Successful Breastfeeding for Hospitals included in the Baby-Friendly Hospital Initiative(BFHI) sponsored by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) is considered the gold standard for breastfeeding maternity practices, no Arizona hospital has earned the "Baby-Friendly" designation. While Arizona hospitals should strive to achieve all ten steps, working toward five practices would go a long way toward making a real difference in the health of infants and mothers.
Arizona had a high percentage of mothers initiate breastfeeding with many mothers discontinuing breastfeeding in the first few days. Pregnancy Risk Assessment Monitoring System data (PRAMS) in Colorado was used to examine the effects of hospital practices on breastfeeding duration and whether the effects differed by income level. The study showed breastfeeding duration was improved for mothers at all income levels with the use of five specific hospital practices. ADHS will utilize the five "Baby Friendly" practices found to increase breastfeeding duration for mothers:
- Initiate breastfeeding within the first hour after birth.
- Avoid giving infants fluids or solids other than breast milk unless medically necessary.
- Promote 24-hour rooming-in, encouraging the family to recognize and respond to infant's cues.
- Do not use a pacifier or artificial nipple with infants during the hospital stay.
- Give mothers a telephone number to call for help with breastfeeding, the ADHS Breastfeeding Hotline 1-800-833-4642
The 2007 CDC mPINC survey results shows gaps in Arizona for success in implementing four of the five model policies. Success was seen for one model policy, as 91.7% of mothers are given a follow-up telephone number when discharged from the hospital. The gaps reported by participating facilities include:
- 32.4% of reporting hospitals indicate that 90% or more of healthy breastfed infants are put to the breast within one hour of an uncomplicated vaginal birth
- 22.9% of healthy breastfed infants receive glucose water/or water
- 54.6% of reporting hospitals indicate healthy full-term infants are with their mothers for at least 23 hours a day
- 44.1% of the infants are given pacifiers by facility staff
To encourage Arizona hospitals to incorporate changes to maternity care policies to include all five of the breastfeeding friendly practices, the Arizona Department of Health Services and the Arizona Perinatal Trust will partner to support these policies in the Arizona Perinatal Trust certification, as well as provide training and technical assistance to hospitals to assure quality assurance.