Breastfeeding-Friendly Healthcare Project supporting the Ten Steps in multiple hospitals settings: Preliminary operational research findings

Background/Purpose: The Breastfeeding-Friendly Healthcare (BFHC) Project was undertaken to increase breastfeeding support through implementation of the Ten Steps for Successful Breastfeeding in hospitals serving low wealth populations. A operational research study was undertaken to assess best practices for effective change.The purpose of this analysis of the baseline information is to assess initial parameters, including differences found in comparable areas. Methods: A multi-methods, phased quasi-experimental design was selected to allow comparison between intervention hospitals and non-intervention hospitals, including e-survey of staff and 2 other self-appraisal tools, key informant interviews, and patient data analysis. Findings/Results: Preliminary analyses reveal no significant differences between intervention and non-intervention hospitals in mean number of births, urbanity, number of staff per birth, age of staff, number of LCs, % White, % C/Sections, and % response to the surveys. In addition, the mean% breastfeeding initiation in the counties served by the two groups is nearly identical, at 60 and 62%. However, baseline data revealed 1) significant differences in the profiles created using different assessment tools, 2) universal lack of inclusion of sufficient breastfeeding data in health information systems, and 3) significant difference in Ten Step practices. Final baseline results, including commonalities and differences among and between the two groups in status of Steps in place, breastfeeding support, breastfeeding rates and additional lessons learned will be presented. Conclusions: Operational research on the Ten Steps can provide insights that will inform implementation of the Surgeon Generals Call to Action to Support Breastfeeding.