Straight to Mom's Chest/No Nursery at UCMC: Breastfeeding Rates Rise
Exclusive breastfeeding (EBF) rates were improved significantly at
University of Cincinnati Medical
Center (UCMC) when the hospital employed bonding measures such as
skin-to-skin contact of mother and baby and rooming-in.
"Delivering in a hospital has amazing benefits, but now it’s
time for us to go back and revisit basic processes,” says Amy
Thompson, MD, an associate professor in the UC College of
Medicine’s Department of Obstetrics and Gynecology and
co-author of a study in
Pediatrics, Volume 139,
online. The study was conducted by experts in breastfeeding,
obstetrics, and pediatrics at UCMC and the
Cincinnati Children’s Hospital
Medical Center (CCHMC).
The manuscript, "Improving Exclusive Breastfeeding in an Urban
Academic Hospital” details the concerted effort of hospital
faculty and staff to raise the number of infants exclusively
breastfed upon hospital discharge from 37 percent to 59 percent by
employing new practices; the most influential being placing the
baby directly on the mother’s chest upon birth and the
removal of the hospital nursery so that babies could "room
in” with mothers.
"Immediately after a normal delivery, everyone is focused on how
much the baby weighs.
In the past a baby
was weighed and even dressed before being held by his or her
In contrast, placing
the baby skin to skin immediately after delivery fulfils an
instinctive process for the baby and leads to long term
breastfeeding success, ” says Thompson.
The hospital also removed the designated nursery, she says,
"because it’s more realistic to what we know happens when a
mother goes home and allows the mother to detect her baby’s
feeding cues so that feedings happen on the baby’s schedule
rather than a nurse’s schedule”
Of course, there is a medical nursery where nurses can take the
baby if it’s absolutely necessary, but as a practice mothers
at UCMC are encouraged to room with their babies, says CCHMC
neonatologist and co-author Laura Ward, MD, an adjunct associate
professor in the Department of Pediatrics at UC.
Says Ward: "
We found that hospital practices
really can impact breastfeeding rates, even in the longer term.
Not only did we have
more moms breastfeeding exclusively in the hospital, we also found
that more were still breastfeeding when they came for a follow up
visit after discharge.”
According to the report, urban academic facilities serve a
population with breastfeeding disparities but there are hospital
breastfeeding practices that can help to end the breastfeeding
disparities which oftentimes parallel socio-economic status.
"If all moms receive prenatal education on the benefits of
breastfeeding and their own breast physiology, and are supported by
trained hospital staff, then we can start to diminish these
disparities, " says Thompson.
Thompson, Ward and colleagues embarked on the project in June 2012,
when the hospital began participation in Best Fed Beginnings (BFB),
a national quality improvement initiative serving populations at
highest risk not to breastfeed. By implementing BFB activities the
hospital was able to achieve Baby- Friendly USA status in December
2014, a national accreditation for birthing facilities.
"We engaged our postpartum teams to adopt a patient-centered
approach rather than provider-centered approach,” which
included conducting newborn assessments at the mother’s
bedside instead of taking the baby to the Newborn Observation Unit,
says Thompson. "We instituted daily quiet times to promote maternal
rest, explaining that rooming-in empowers mothers to care for their
infants and encourage maternal recognition of feeding cues.”
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