UH Rainbow Expert Plays Key Role in Statewide Breastfeeding Initiative

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Collaborating in the community for healthier babies

UH Innovations in Pediatrics - Summer | 2019

What happens when maternity hospitals, the state hospital association, the state department of health and a variety of breastfeeding groups and experts collaborate in a systematic effort to boost breastfeeding rates? In Ohio, the answer is increased rates of breastfeeding initiation, continuation and exclusivity over time.

First Steps for Healthy Babies began in Ohio in 2015, led by the Ohio Department of Health and the Ohio Hospital Association. Modeled after a similar program in North Carolina, the program allows hospitals to apply for “stars,” based on how many of the program’s 10 breastfeeding-supportive maternity practices they can document that they’ve achieved. For each two steps mastered, the hospital earns one star. Hospitals can choose which steps to implement and in which order.

“First Steps is an amazing program,” says Lydia Furman, MD, a pediatrician and breastfeeding expert at UH Rainbow Babies & Children’s Hospital; and Professor of Pediatrics at Case Western Reserve University School of Medicine, who serves on the designation team of First Steps. “It is different from Baby-Friendly designation. Although we also have 10 steps, it is more accessible and it gives hospitals a start to beginning to do the work that is ultimately needed for Baby-Friendly designation. It’s about beginning to do quality improvement, beginning to have processes for change. If you’re looking to do 24/7 rooming in, what do you do with that space that used to be the nursery? What do you do with babies who are in the rooms – how do you keep them safe? Some of the steps cause a lot of changes to nursing processes and physician processes, so it’s really beginning that and getting help coaching and then recognition.” 

Lydia Furman, MD Lydia Furman, MD

“Becoming Baby Friendly is a very resource-intensive task,” adds Ryan Everett, MPH, from the Ohio Hospital Association. “There’s a cost to being designated, and there’s a cost to training all of your staff. Everything in our program is free for hospitals to utilize. For hospitals that don’t have the resources to currently strive for Baby-Friendly, it gives them targets they can work towards while making improvements to support their moms and families in their breastfeeding goals.”

Reaction to the program has been extremely positive, Dr. Furman says. Of 103 obstetrics hospitals in Ohio, 98 percent are participating in some aspect of the program. Eighty-six (86) of that 103 have earned at least one star.

“We really are saturated across the state,” she says. “The fact that the program is co-led by the Ohio Department of Health and the Ohio Hospital Association gives it a legitimacy that people appreciate. Ongoing work of both Bre Haviland of the Ohio Department of Health and Ryan Everett of the Ohio Hospital Association are what make the program possible.”

Maternity hospitals participating in First Steps for Healthy Babies have access to a free online resource guide, free online webinars, free statewide “train the trainer” programs in support of specific steps and free handouts, posters and flip charts to support maternity practices. Materials produced by First Steps have been distributed nationally to American Academy of Pediatrics Chapter Breastfeeding Coordinators and have been shared with birthing hospitals in other states. 

“People are thrilled with the materials,” Dr. Furman says. “They can take the templates that are there, which are completely free, and customize them for their own hospitals.”

Dr. Furman and her colleagues are currently documenting their experience with First Steps to share with their colleagues nationwide.
“We are among the first to share in the medical literature what we’re doing, but it is spreading all around the country,” she says.

And while they can’t claim a cause-and-effect relationship, she says the First Steps team has been pleased with the improvements in Ohio’s breastfeeding rates since the program began.

“Rates of breastfeeding in the state of Ohio have increased significantly over the time that the program has been active,” Dr. Furman says. “People seem to be excited about what First Steps is and what it is doing. It’s a really fun collaboration.”  

For more information about Ohio’s First Steps for Healthy Babies program, please visit its website at ohiohospitals.org/ohiofirststeps or contact Dr. Lydia Furman at Peds.Innovations@UHhospitals.org.

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