Washington County Department of Public Health and Environment
Combined Results of the BFH Self Assessment
1/11
INTERVENTION: C-N-HC1: Health Care Breastfeeding Support - Implement breastfeeding
practices in maternity care that provides prenatal, birth, and postpartum services to support
breastfeeding
Problem/Situation
While breastfeeding initiation rates are quite high at 80-90% in Washington County the duration rates
are much lower at 53% (WIC data at six months). Breastfed babies are less likely to become overweight
or obese children or adolescents compared to babies who are exclusively bottle-fed. Parents need
more consistent messages throughout the continuum of care in order to breastfeed successfully.
Aim
By July 1, 2010, all three hospitals serving Washington County will register for the Baby Friendly Hospital
(BFH) designation.
By January 1, 2011, at least one of the hospitals serving Washington County will complete the discovery
phase of the BFH 4D Pathway.
Process Measures
1. Number of hospitals that complete the BFH Self Appraisal Tool by July 1, 2010.
2. Number of hospital CEOs who write letters of support.
3. Number of hospitals that develop action plans to improve breastfeeding support practices.
4. Draft of individual hospital breastfeeding policies.
Outcome Measures
Number of hospitals in Washington County that complete the development phase of the BFH 4D pathway. See BFH attachment.
KEY ACTION STEPS
1. Met with each of the three hospitals serving Washington County to determine their interest/capacity
to work toward the BFH Designation.
2. Developed and implemented a contract process with three hospitals including one lead agency
role – see flow chart of contract process.
3. Communicate and support the BFH standards and application process in each of the hospitals
recognizing their individual differences and limitations.
4. Collected results of BFH self-appraisal tool. See chart of combined results.
5. Established a countywide Breastfeeding Coalition (BFC) to provide networking and support for
improved breastfeeding practices in the member organizations and community.
ANALYSIS
Contracts and coalition building among competing partners has to be done carefully and takes
time and patience.
Individual champions within each hospital were essential to initiate the BFH process. The Breastfeeding Coalition (BFC) of key partners throughout the county has been essential to our success
by providing an avenue for networking; building support; exchange of expertise; creation of a
resource tool; staff training; and policy development.
Obstacles, such as staff changes can become opportunities further into the process because
they create more discussion, and support ultimately leading to a stronger commitment.
The self assessment results show that several areas are consistently lower countywide: benefits of
BF, exclusive breast milk practices and communicating breastfeeding policies.
RESULTS/OUTCOMES
All three hospitals completed registration for BFH by September 2010.
Two hospitals completed the discovery phase by early 2011. The next phase of the 4D pathway is
the development phase which is expected to continue through June 2011. The last two phases
could take up to an additional year each.
All three hospitals completed the appraisal tool by December 2010
Two CEOs have written letters of support to BFH
Action plans will be developed as two of the hospitals move into the development phase of
BFH. The third hospital will develop an action plan based on their assessment results.
Two out of three hospitals already have breastfeeding policies that will be updated as they move
through the BFH process. The third hospital will be developing a policy as well.
LESSONS LEARNED
The contract process took more time than anticipated and was unique to each partner system.
Talking to the “right people”, those that can make the decisions, makes the process go much
smoother.
Hospitals need support to work through the BFH process – ultimately the coalition is the best peer
support because public health agencies cannot apply for BFH.