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Pick Low Hanging Fruit First

Those working towards the Baby-Friendly Hospital Initiative often find it is a complex, sometimes harder road, than they anticipated.  Picking some of the easy “low hanging fruit” and getting some early successes can help the staff working on this project move forward with enthusiasm.

Implementing skin-to-skin care (Step 4) as one of the first strategies often does not meet with much resistance, and can yield impressive results in initiation of breastfeeding and patient satisfaction scores.  McKeever found that infants in skin-to-skin care did not become hypothermic, most breastfed within an hour and they continued to successfully breastfeed the second day.  In addition mothers remarked on the bonding effects (McKeever).  Mothers who did not experience immediate skin-to-skin care demonstrated more roughness in their behaviors with their infants, difficulty with latch-on and infants showed a lack of wakefulness during breastfeeding (Dumas).

Easier to implement steps may include Step 3 (inform pregnant women about breastfeeding), and Step 5 (show mothers how to breastfeed), and Step 8 (encourage breastfeeding on demand).  Provide breastfeeding information in childbirth and lactation classes.  Encourage prenatal clinics and offices to recommend breastfeeding to their clients.  Hospital staff is already showing mothers how to position and latch-on babies.  Technique can be improved to be more effective through staff education.  And flexibility in feeding schedules is probably in place, but can be encouraged. So start with these steps, then tackle the more difficult ones: Step 1 (breastfeeding policy), Step 6 (give nothing but breastmilk) and Step 7 (rooming-in) (Semenic).

Most managers implementing Baby-Friendly practices find that a gradual and step-wise approach works best.  Make the most of the “easy to change behaviors” to get some momentum going and the rest will follow, eventually.

NEW GUEST BLOG FEATURE: Why Did I Become a LC?

I know you all have great stories about your experiences being or working toward becoming a lactation consultant. Well now we have created a forum for you to share your stories with others. We invite you to write a meximum 100-word essay on who or what influenced you and what experiences encouraged you to enter the rewarding field of lactation consulting. To submit your essay, click on this link -https://lactationtraining.formstack.com/forms/ler_blog_submission.

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References:

Dumas L, Lepage M, Bystrove K, et al.  The influence of skin to skin contact and rooming-in on early mother-infant interaction: A randomized control trial.  Clin Nurs Res.  August 2013;22(3):310-336.

McKeever J, St Fleur R.  Overcoming barriers to baby-friendly status.  J Hum Lact.  Aug 2012:28(3):312-314.

Semenic S, Childerhose JE, Lauzière J, Groleau D.Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): an integrative review.  J Hum Lact. 2012 Aug;28(3):317-34.

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About the author

Vergie Hughes

Vergie Hughes

Vergie Hughes has a long history of experience in Maternal Child Health including labor and delivery, post-partum and pediatrics, and for the past 25 years she has been involved in lactation management. Ms. Hughes has a BSN from Pacific Lutheran University and a MS from Georgetown University. She has been a board certified lactation consultant since 1985. At Georgetown University Hospital, she was the director of the Human Milk Bank. She created and developed the National Capitol Lactation Center and the one week Lactation Consultant Training Program. This course has trained more than 4,000 Lactation Consultants since its inception in 1990.


She has been a private practice lactation consultant and business owner, and operated her own lactation center, Washington’s Families First. Lactation Education Resources On-Line is her website, offering training to professionals and information to parents as well. Ms. Hughes has served on the International Board of Lactation Consultant Examiners and has served on the IBLCE exam writing committee. Her first love is teaching and that is exemplified by the creativity of the courses she has developed. A series of courses “The In-patient Breastfeeding Specialist,” "The Out-patient Breastfeeding Specialist” and “The NICU Breastfeeding Specialist” are all designed to advance the lactation management skills of nurses at the bedside. She regularly teaches skills to labor and delivery nurses and just recently developed the course “Towards Exclusive Breastfeeding.”


Ms. Hughes is the program director and content manager for all of the on-line Lactation Education Resources courses. Ms. Hughes was recently honored with a “lifetime achievement award” as Fellow of the International Lactation Consultant Association (FILCA).

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