262365 Exclusively breastfed: What effect has the change in JCAHO reporting had on breastfeeding policy and rates?

Tuesday, October 30, 2012 : 4:30 PM - 4:45 PM

Ryan Butterfield, MPH, DrPH(c) , Jiann-Ping Hsu College of Public Health, Center for Biostatistics, Georgia Southern University and University of Florida, Jacksonville, FL
Katryne Lukens Bull, MPH , Institute for Public Health Infomatics and Research, Florida Department of Health, Duval County, Jacksonville, FL
Ashley Ridlen , Sociology and Anthropology, University of North Florida, Jacksonville, FL
Background: Studies have demonstrated the value of breastfeeding for both the infant and the mother's health and wellbeing. Although the value of breastfeeding is well known, institutional systems remain in place which impede the breastfeeding relationship. The Baby Friendly Hospital Initiative (BFHI) identifies ten steps to addressing these institutional barriers. Studies have shown increases in both initiation and duration when hospital practices are changed to support breastfeeding through the implementation of BFHI steps. Still, many hospitals are reluctant to implement these steps with only 125 US hospitals and birth centers, including four Florida hospitals, being Baby Friendly. In 2010, the Joint Commission for Accreditation of Healthcare Organizations (JCAHO), implemented a new set of guidelines for the reporting of “exclusively breastfed.” Hospitals in Northeast Florida struggled to implement these reporting changes and many witnessed their former breastfeeding rates decline with the new definition. The Northeast Florida Lactation Coalition (NFLC), along with academic and public health partners, has intensified their push for policy changes within the healthcare delivery system. The purpose of this paper is to examine how the 2010 change in JCAHO reporting of breastfeeding rates to a new definition of “exclusively breastfed” affected the breastfeeding rates of hospitals participating in the Northeast Florida Lactation Coalition. Methods: Data was examined between 2008 – 2009 when the definition of “mostly breastfed” was used by hospitals for reporting and 2010-2011 when the definition was changed to “exclusively breastfed.” Results: Between 2008/09 and 2010/11 there was a mean decrease in the number of infants reported as breastfed (90.96 S.D. 17.38 and 49.93 S.D. 13.33). This was a decrease of 45.1% between the reporting periods. Hospital policy changes building towards Baby-Friendly will be discussed along with current trends in exclusive breastfeeding over time and by inter-county region.

Learning Areas:
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Learners will be able to describe how the 2010 change in JCAHO reporting of breastfeeding from “breastfeeding” to “exclusively breastfeeding” upon discharge effected the breastfeeding rates of hospitals participating in the Northeast Florida Breastfeeding Coalition. Learners will be able to describe changes in hospital policy and practices 2008 - 2011 for hospitals participating in the Northeast Florida Breastfeeding Coalition.

Keywords: Breastfeeding, Policy/Policy Development

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have implemented research, evaluation and public health programs for over 15 years. I have been a member of the NE Florida Lactation Coalition, LLL, and an Attachment Parenting International Leader for over 10 years. In my work with the Coalition, we have formed a community-academic partnership to implement quality improvement, data collection and analysis, and policy change to promote breastfeeding.
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.