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D-H Continues Commitment to Baby-Friendly Designation

D-H Continues Commitment to Baby-Friendly Designation

Breastfeeding is a simple act with a big impact.

Maria Padin, MD

“Breastfeeding is a simple act with a big impact,” says Maria Padin, MD, chief medical officer, Dartmouth-Hitchcock Medical Center (DHMC). “It reduces risk of childhood illness, preserves gut biome for the whole life of the child, and strengthens the mother-baby bond and family structure. Encouraging healthy starts through breastfeeding is the first step in improving population health.”

Dartmouth-Hitchcock’s (D-H’s) adherence to best practices in breastfeeding education and support was recognized by Baby-Friendly designation in 2012. Administered by the World Health Organization (WHO), the global program requires re-designation every five years.

A multi-disciplinary team lead by Lisa Lamadriz, MPH, RN, IBCLC, clinical nurse and lactation coordinator, is currently preparing D-H for reassessment, which is expected to take place this summer. Padin and Lamadriz explain Baby-Friendly designation and the re-designation process.

Q: How does Baby-Friendly designation benefit D-H patients and staff?

Lamadriz: Baby-Friendly designation provides a framework to sustain our efforts to provide consistent evidence-based breastfeeding care for families delivering at DHMC. Through this initiative we have improved breastfeeding rates, exclusive breastfeeding rates and have reduced formula supplementation from 36 percent down to 10 percent. Additionally, DHMC provides pasteurized donor breast milk for breastfeeding families and fragile infants who require supplementation.

We’re also focused on keeping moms and babies together during their hospital stay with no more than a one hour of separation. This assures that the parents learn their baby’s feeding cues, and that the cues are responded to quickly.

Padin: As a leading academic medical center, we’re responsible to model best practices. The Baby-Friendly program equips staff with the evidence-based tools and structure moms and babies need for successful breastfeeding. Designation also helps with recruiting. Nurses like working in Baby-Friendly hospitals.

Q: How will D-H attain re-designation?

Lamadriz: Baby-Friendly assessors want to see that our patients understand the benefits of breastfeeding and are receiving education and support. Are we teaching proper technique? Do parents understand on-demand feeding? Can moms hand express? They will also make sure all D-H staff interacting with nursing moms and babies are knowledgeable and able to provide assistance.

As part of the re-designation process, Baby-Friendly assessors will interview mothers, nurses and providers who care for mothers and their babies. Interviews will be conducted with at least 10 prenatal and post-partum, breastfeeding and formula-feeding moms on the Birthing Pavilion; 25 who have been discharged; and about 10 in the prenatal clinic. Every Birthing Pavilion staff member will be interviewed and so will physicians. DHMC will receive re-designation by demonstrating that we meet benchmarks of 80 percent or higher compliance with the “Ten Steps of Successful Breastfeeding.”

Q: Have there been areas to focus on since first being accredited in 2012?

Lamadriz: Rather than presenting new requirements every five years, the Baby-Friendly program looks for continuous quality improvement. We are required to submit data annually to demonstrate that we are sustaining breastfeeding quality improvement benchmarks.

Baby-Friendly has updated their requirements since our first designation regarding safe infant formula preparation. So we implemented new education for formula feeding. Formula powder can contain bacteria for prolonged periods of time, so based on recommendations from the CDC [Centers for Disease Control and Prevention] and WHO we now teach parents how to clean their equipment and prepare powdered formula safely. We also teach them to feed their baby by watching the baby’s cues, not the clock and to feed until their baby is content.

Q: Who is working on the re-designation?

Lamadriz: Our team includes Birthing Pavilion leaders Emily Brayton, RN, Jennifer Martin Benware, RN, unit supervisor, and Colleen Whatley, CNS; Briana White, RN, nurse educator for CHaD [Children’s Hospital at Dartmouth-Hitchcock]; CHaD leadership; and the Lactation Team. We also rely on the support of senior leaders including Karen Clements, RN, FACHE, our chief nursing officer, Michelle Buck, MSN, RN, inpatient nursing director, and Dr. Padin. Marketing staff helps to publicize our Baby-Friendly status.

Padin: Baby-Friendly re-designation is a team effort and so is Baby-Friendly practice. I’m very grateful for the great group of leaders and practitioners in departments throughout the institution who do this important work so well.


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