Applying a quality improvement approach to increase Baby-Friendly designation in U.S. hospitals

The environment in which a mother delivers her infant, and in which the infant spends their first days of life, exerts a strong influence on the likelihood that the mother will initiate breastfeeding and continue to breastfeed her infant for an extended period of time. The Ten Steps to Successful Breastfeeding and associated Baby-Friendly Designation characterize hospital environments that promote breastfeeding.

Best Fed Beginnings is a quality improvement initiative designed to help hospitals nationwide make changes to maternity care policies and practices to better support mothers to be able to breastfeed their babies. Sponsored by the Centers for Disease Control and Prevention and conducted by the National Initiative for Children's Healthcare Quality, this initiative features an 18-month quality improvement learning collaborative composed of up to 90 teams from hospitals across the US, focusing on hospitals serving racially, ethnically, and geographically disadvantaged populations. The learning collaborative applies quality improvement methods to help hospitals progress through the 4-D pathway to Baby-Friendly designation and to address common barriers in achieving designation.

This session will detail the aims and activities of the learning collaborative with a special focus on the underlying improvement science driving the project. We will describe the improvement model developed to rapidly spread strategies for successful promotion of and address barriers to exclusive breastfeeding practice. We will overview the project's theory of change and measurement strategy for leveraging improvement science to increase Baby-Friendly designation among hospitals in the US.