Small New York Hospital and WIC Collaborate on Big Changes

Posted April 06, 2017 by Sonya Spillman, RN

Pumping Breast Milk
Giving moms the tools they need to breastfeed empowers them to commit to their breastfeeding plans. 

Consistent education about breastfeeding and awareness of available support are key components to improving breastfeeding rates. Collaboration among community health partners that support moms from pre- to post-natal is also essential.

As a part of the New York State Breastfeeding Quality Improvement in Hospitals (BQHI) Collaborative, an initiative to increase the number and length of babies exclusively breastfed, Oswego Hospital and Oswego county’s Women Infant and Children (WIC) staff have partnered to better serve mothers who want to breastfeed.

Oswego Hospital in upstate New York averages 525 deliveries a year, and through this initiative, the hospital staff and WIC collaborate to offer every mom practical support and a consistent message about breastfeeding before, during and after delivery.   

“Whatever breastfeeding goal a mom has, that’s the goal we’re working on,” says MaryEllen Pierce, CDN, IBCLC, who works for WIC in Oswego county. “We want the messages to be clear for the patient going in to deliver about the benefits of breastfeeding to both mom and baby, the in-hospital policies to encourage breastfeeding, and the resources available after discharge.”

The Oswego team, consisting of Pierce, obstetric and neonatal staff, a mother partner, and led by Kathy Distin, RNC, BSN, IBCLC, meets one to two times per month to discuss successes in breastfeeding initiation and duration, changes in policy or practice at the hospital, and plans for the future. Hospital practice changes, based on the Ten Steps to Successful Breastfeeding, include increasing rooming-in time, encouraging skin-to-skin contact between mom and baby, and letting mom and baby recover in the same space after a Caesarean section.

Pre-Hospital Support

Distin offers monthly evening breastfeeding classes antenatally for moms to learn about breastfeeding, as well as what to expect while in the hospital. She explains the benefits of breastfeeding and rationale behind hospital practices, like skin-to-skin contact, initiating breastfeeding within the first hour, and rooming in.

The Oswego WIC office reinforces this information as well, through a delivery packet given to every mom at her last visit before giving birth. The packet includes information on hunger cues, hand expression, what to expect in the first days after birth, online resources and more.

In-Hospital Support

The Oswego team has come up with practical changes at the hospital in an effort to increase breastfeeding rates. They now provide specialized hospital gowns for increased modesty for nursing mothers who often have many visitors during their stay. Upon admission to the delivery unit, nurses give out an informational sheet on feeding cues which the team developed to reinforce their verbal teaching.

A lactation consultant, Distin makes face-to-face visits or calls to check in with every breastfeeding mother during her hospital stay. “I always encourage a mom to contact their peer counselor before they leave the hospital,” she says. Peer Counselors, who can visit a mother while she is in the hospital, are available to every mom in the WIC program planning to breastfeed, but contact must be mom-initiated and mom-directed.

Post-Hospital Support
After discharge, Distin offers free lactation consultations for moms who need help breastfeeding and follows up with a phone call a few weeks after delivery. WIC has breast pumps available to eligible women and employs five peer counselors for face-to-face breastfeeding support.

“Maybe a mom is struggling a few days after delivery and doesn’t feel comfortable leaving their home with a newborn. The peer counselor can go to their house and help with positioning, nursing and answer questions. Counselors can help them in person, as opposed to one of us doing it over the phone,” says Distin.

After birth, WIC has a large influence on new moms in their community. “We want to reinforce and provide a consistent message,” says Pierce. “Our goal is for them to leave the hospital breastfeeding and then support them, to keep them breastfeeding.”

For example, if a mom plans to go back to work while breastfeeding, Pierce speaks with employers and encourages them to provide time and a place for pumping. She also worked with the community university to identify areas for nursing and pumping moms on the local campuses, and she has a future goal to offer a breastfeeding tent at regional festivals and at Oswego’s farmer’s market.

This semi-rural population has its share of barriers to breastfeeding, like lack of transportation to appointments, beliefs about breastfeeding and smoking and quick returns to work for new moms. Yet, the team is confident that given time, there will be a positive correlation between the evidence-based changes being implemented and increased breastfeeding rates.

Central to the work of improving breastfeeding outcomes, in our communities and across the country, is the role of partnerships along the breastfeeding continuum. As we work together we will provide all mothers with the opportunity and resources that give them the chance to choose to breastfeed and to reach success in that choice. The collaboration between WIC and Oswego Hospital is an example of how partners are empowering women to start and continue their breastfeeding journey. Pierce says, “The more we talk to moms about what to expect and give them support within the community, the more they feel like they can do it.” 

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