Building a city-wide breastfeeding promotion initiative in a large, multi-site, public-hospital system

The New York City Health and Hospitals Corporation (HHC), the largest US public hospital system, serves 1.3 million New Yorkers. In 2007, HHC implemented a corporate-wide (11 hospitals) Breastfeeding Promotion Initiative (BPI) to foster breastfeeding or the use of mother's milk, as the preferred nutrition for infants. The program is based on the BabyFriendly USA® “Ten Steps to Successful Breastfeeding”. In 2008, HHC's Harlem Hospital received the first BabyFriendly certification in New York City and second in New York State.

HHC established a multi-disciplinary breastfeeding Working Group including clinical, administrative, and operations staff across HHC to standardize existing policies, procedures, and practices, and establish a uniform breastfeeding promotion model. The Working Group developed HHC's first Corporate Breastfeeding Policy based on best- and evidence-based medical practices. The Work Group oversees program development and implementation at Corporate facilities from clinical and operational perspectives and formed education (provider and patient) and performance evaluation sub-groups. These teams facilitated implementation of provider education at all sites, loaner pump programs, a newborn home visiting pilot program at three facilities thus far, enhancement of existing patient education materials and support, and a standardized data collection process to capture key program metrics. In addition, HHC eliminated the practice of providing mothers with formula company gift bags and imposed a ban on formula promotion materials. Instead, mothers receive an HHC breastfeeding friendly bag including educational materials and an ice pack and cooler to enable parents to travel with breast milk.