The Journey to Create a Baby-Friendly District of Columbia

At A Glance

In 2013, the DC Breastfeeding Coalition (DCBFC) launched the Creating a Baby-Friendly District of Columbia Initiative to reduce breastfeeding disparities in Washington, DC. Three DC hospitals received staff training, technical assistance, and evaluation to improve breastfeeding-related care practices. Since 2014, the DCBFC has leveraged additional funding, and is working to ensure that all babies born in DC are delivered in a Baby-Friendly designated facility by 2025.

By Sahira Long, MD, Medical Director, Children's Health Center - Anacostia

Public Health Challenge

In DC, rates of breastfeeding are much lower for African Americans than non-Hispanic whites. According to the US National Immunization Survey, 96% of DC’s white infants were ever breastfed, compared to 66% of African American infants. Likewise, 48% of white infants were breastfed for the recommended 12 months, compared to 16% of African American infants. Research has shown that women have better breastfeeding outcomes when they give birth at Baby-Friendly designated facilities. In 2012, DC achieved its first Baby-Friendly designation, at the MedStar Georgetown University Hospital. This notable achievement was a good first step for the DC area, but MedStar Georgetown serves an affluent community where breastfeeding was already the norm.

Approach

In 2013, the DCBFC launched the Creating a Baby-Friendly District of Columbia Initiative to train more hospital staff in breastfeeding best practices. Through a competitive process, three DC facilities were selected to receive funding and technical assistance to follow the Baby-Friendly USA pathway to designation. The facilities were selected based on their ability to serve low-income DC residents in neighborhoods with low breastfeeding rates. The DCBFC trained staff from the three facilities in maternity best practices, and provided technical assistance to implement the Ten Steps to Successful Breastfeeding: https://www.babyfriendlyusa.org/about-us/10-steps-and-international-code

Baby-Friendly designation is an inclusion tool that, when achieved in all DC birthing facilities, will ensure that all babies receive the same care that is supportive of mother-infant bonding and breastfeeding, regardless of place or race.
- Mudiwah Kadeshe, MSN, RN, IBCLC, DC Breastfeeding Coalition

Results

The initiative reached 6,408 mother-baby pairs. All three participating hospitals trained staff with the clinical lactation skills training required for Baby-Friendly USA designation. Facility A trained 100% of registered nurses (RNs) and advanced practice nurses (APNs), while facility B trained 88% and facility C trained 32% of RNs and APNs, respectively. Each facility designated selected staff to undergo a train-the-trainer curriculum facilitated by Lactation Education Resources. All three facilities have entered the Baby-Friendly USA pathway. With additional funding from the DC Department of Health and the Centers for Disease Control and Prevention (CDC), the DCBFC helped two of the DC facilities achieve Baby-Friendly USA designation (one is no longer providing maternity services).

What's Next

The DCBFC provides support and technical assistance to all interested DC hospitals with maternity services to help them achieve and maintain Baby-Friendly designation. A major focus of these efforts is to provide breastfeeding education and support to mothers before and after leaving the hospital. To meet the needs of mothers at risk of not breastfeeding, the DCBFC will provide both community-based and app-based peer and professional breastfeeding support. This support includes free prenatal breastfeeding education in hospitals and the community, and helping community facilities to provide breastfeeding supportive environments.

Find Out More

Learn more about the Creating a Baby-Friendly District of Columbia Initiative by visiting www.dcbfc.org. To learn more about the Baby-Friendly USA designation program, visit https://www.babyfriendlyusa.org. This initiative was supported in part by CDC’s DP12-1216 PPHF12 Small Communities Award.

Contact

Sahira Long, MD, Medical Director, Children's Health Center - Anacostia

2101 Martin Luther King, Jr. Ave, SE
5th Floor
Washington, GA
Phone: 202-475-6900

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).