241435 Assess, address and proceed: Moving beyond na´ve impressions of the Baby Friendly Hospital Initiative among hospital administrators

Tuesday, November 1, 2011: 11:10 AM

Emily C. Taylor, MPH, CD(DONA), LCCE , Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, NC
Nathan C. Nickel, MPH , Carolina Global Breastfeeding Institute, Department of Maternal and Child Health, Gillings School of Global Public Health at the University of North Carolina-Chapel Hill, Chapel Hill, NC
Miriam Labbok, MD, MPH, FACPM, IBCLC, FABM , Carolina Global Breastfeeding Institute, Department of Maternal Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
Background/Purpose: The Surgeon General's Call to Action to Support Breastfeeding and Healthy People 2020 call upon hospitals to implement the Ten Steps to Successful Breastfeeding. Nonetheless, many hospitals delay or avoid implementation, citing multiple barriers. Some of these barriers are real, but others are misconceptions. This study assesses an intervention to change perceptions in a sample of maternities in North Carolina.

Data & Methods: We conducted a survey of healthcare providers as part of baseline and mid-point assessment for the Breastfeeding-Friendly Healthcare Project. The survey assessed knowledge, attitudes and practices concerning the Ten Steps. We also conducted semi-structured key informant interviews, and semi-structured group discussions.

Results: Multiple na´ve perceptions were expressed prior to intervention, such as:1) Baby Friendly hospitals cannot stock formula; 2) Formula manufacturers always require distribution of advertising materials in exchange for free formula; 3) The cost of purchasing formula is highly prohibitive; 4) The required training is prohibitively expensive. Following educational and consultative intervention, many of these misperceptions were replaced with accurate understandings. Most perceptions of cost barriers were alleviated, with perception of the high cost of purchasing formula less affected. Once these misperceptions were addressed, all participants engaged in developing creative solutions to implementing the Ten Steps for quality improvement.

Conclusions: Hospital staff members' impressions of Baby Friendly and the Ten Steps are amenable to change through education. Expert guidance, print materials and inter-hospital consultation support the transition to learned understandings. We hypothesize that this paradigm shift must occur before significant practice change will occur.

Learning Areas:
Administration, management, leadership
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Planning of health education strategies, interventions, and programs
Program planning

Learning Objectives:
Identify five misperceptions about Baby Friendly Hospital Initiative and the Ten Steps to Successful Breastfeeding commonly held by hospital administrators and care providers. Describe two interventions with demonstrated success in supporting the transition to learned understandings (to facilitate practice change).

Keywords: Breast Feeding, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the program director for the research being presented. I am experienced and trained in quality improvement in the maternity, and mixed-methods research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.