Baby-Friendly for Those Most in Need: Using Vital Statistics Birth Records to Select Hospitals for Baby-Friendly Funding and Support

Tuesday, June 21, 2016: 4:44 PM
Tubughnenq' 6 / Boardroom, Dena'ina Convention Center
Jamie Forrest , Florida Department of Health, Tallahassee, FL
Julie Dudley , Florida Department of Health, Tallahassee, FL
BACKGROUND:  

Breastfeeding lowers risks for certain diseases, improves health outcomes, and has a positive impact on weight for both infants and mothers. Maternity policies and practices in hospitals and birth centers can significantly affect breastfeeding initiation, duration, and exclusivity.

The Baby-Friendly Hospital Initiative, a global program launched by the World Health Organization and the United Nations Children's Fund, encourages and recognizes hospitals and birthing facilities that offer the finest care for infant feeding and mother/baby bonding. Facilities must adhere to the Ten Steps to Successful Breastfeeding to receive, and retain, a Baby-Friendly designation.

Funding from Florida’s Preventive Health and Health Services Block Grant was earmarked to support collaboration between Local Health Offices and birthing facilities to accomplish the Ten Steps to Successful Breastfeeding.  A data-driven approach was taken to direct funding to areas with low breastfeeding initiation rates and high levels of community interest.  

METHODS:  

A two-step method was used to identify Local Health Offices for collaboration.  One step involved surveying Local Health Offices to determine those most receptive to implementing a community wide approach to creating breastfeeding friendly environments.  The other step involved analyzing birth records obtained from the Florida Department of Health’s Bureau of Vital Statistics to determine the 2013 breastfeeding initiation rates by county.  Birth records from the 20 counties with the lowest breastfeeding initiation were grouped together into a new variable, which was used to identify the birthing facilities serving the largest number of women from these counties.  

RESULTS:  

Twelve Local Health Offices indicated interest in implementing a special project related to “Breastfeeding/Baby-Friendly Hospitals”.  In 2013, four out of five Florida mothers (82.5%) initiated breastfeeding.  The breastfeeding initiation rate varied greatly, ranging from 45.3% to 91.3% across Florida’s 67 counties.  Among the 20 counties with the lowest breastfeeding initiation rates, the average rate was 62.1%.  Only six of these 20 counties had a birthing facility, meaning women from the remaining 14 counties had to travel to neighboring counties for birthing services.

CONCLUSIONS:  

Fifteen Local Health Offices were funded to provided mini-grants, technical assistance, and support to 24 birthing facilities to work towards achieving the Ten Steps to Successful Breastfeeding.  Six of the 15 funded counties had expressed interest, and 11 of the funded counties had birthing facilities serving women from the 20 counties with the lowest breastfeeding initiation rates.  Combining these two approaches enabled funding to be allocated where it was wanted and needed.