Better Maternity Care Practices Lead to Increases in Breastfeeding in Hawaii

At A Glance

In 2010, the Hawaii State Department launched the Baby-Friendly Hawaii Project (BFHP). The BFHP is based on the Ten Steps to Successful Breastfeeding (Ten Steps). The BFHP aims to increase the number of hospitals providing maternity care that aligns with the Ten Steps and the percentage of women who breastfeed exclusively throughout their hospital stay. During the BFHP project period, supportive breastfeeding practices and breastfeeding improved in Hawaii. Exclusive breastfeeding throughout hospital stay increased by almost 20%.

By Heidi Hansen Smith

Public Health Challenge

Breastfeeding is the best method for infant feeding. In the United States, 83% of mothers began breastfeeding in 2014; however, only 47% and 25% of mothers were exclusively breastfeeding at 3 and 6 months, respectively. Hospital maternity care practices can positively influence breastfeeding behaviors. In 2009, Hawaii scored 65 (out of 100) on the Centers for Disease Control and Prevention’s (CDC’s) national survey of Maternity Practices in Infant Nutrition and Care (mPINC). Developed in 2007, mPINC is a hospital self-reported survey that monitors breastfeeding-associated maternity practices among all US birthing facilities. Hawaii’s 2009 detailed state report found that hospitals needed improvements in several areas, including comprehensive breastfeeding policies and staff competency for breastfeeding support.

Approach

To increase the percentage of newborns who breastfeed exclusively throughout their hospital stay, BFHP was offered to all 11 birthing hospitals in Hawaii. The BFHP helped hospitals use evidence-based strategies, as outlined in the Ten Steps, by providing ongoing technical assistance, training staff, building capacity, assessing maternity practices, and monitoring progress. The BFHP also worked with hospitals to identify staff “champions.” Selected champions went on to train staff at their respective hospitals and had the opportunity to influence hospital practices and policies.

The Hawaii Department of Health has shown ongoing commitment to engage all of the birthing hospitals in Hawaii. By helping these hospitals implement the Ten Steps to Baby-Friendly, the hospital environments have changed, as shown in the outcome data
- Carolyn Lopez Melcher, MPH, BSN, RN, Project Consultant, Baby Friendly Hawaii Project

Results

All 11 maternity hospitals in Hawaii participated in the BFHP. While the project was running, Hawaii’s mPINC score increased from 65 (out of 100) in 2009 to 76 in 2011 to 80 in 2013 and 2015. Newborn Screening Data also showed an increase in statewide exclusive breastfeeding throughout hospital stay, from 59.7% in 2009 to 77.0% in 2014. The BFHP provided 58 trainings, 52 hospital site visits, and ongoing technical assistance during the project. As a result, over 750 staff and health professionals from BFHP hospitals were trained.

What's Next

To promote program sustainability, the BFHP encourages hospitals to develop policies that promote breastfeeding. The Hawaii State Department of Health has also committed state resources and continued the project since the end of the CPPW funding.

Find Out More

To learn more about the BHFP, visit http://health.hawaii.gov/physical-activity-nutrition/home/breastfeeding-baby-friendly-hawaii-project/ and https://www.cdc.gov/breastfeeding/pdf/mpinc/states/2015/hawaii-2015-mpinc-report.pdfThis project was funded by CDC through the Communities Putting Prevention to Work (CPPW) initiative and the Hawaii Department of Health’s Healthy Hawaii Initiative Tobacco Settlement Special Fund.

Contact

Heidi Hansen Smith
CDC
Department of Health
1250 Punchbowl St. #210
Honolulu, GA 96813
Phone: 808-586-4795

Centers for Disease Control and Prevention

Web site

http://nccd.cdc.gov/nccdsuccessstories/

CDC-INFO

https://wwwn.cdc.gov/dcs/ContactUs/Form

The findings and conclusions in this success story are those of the author(s) and do not necessarily represent the official position of the funding agencies or the Centers for Disease Control and Prevention (CDC).