Massachusetts Baby-Friendly Collaborative: Synergy on a Shoestring

Background: In 2008, Massachusetts had only 1 Baby-Friendly Hospital out of 50, with 4 other maternity centers committed to the process. Few states were using a statewide collaborative model for quality improvement projects of any nature for changing breastfeeding practices.

Methods: With the endorsement of the state health department, the Massachusetts Breastfeeding Coalition launched the state’s Baby-Friendly Collaborative, which became an integral part of a multipronged approach to accelerate statewide change. With a minimal budget, the Collaborative was able to work synergistically with the annual Mother-Baby Summit, Baby-Friendly trainings sponsored by the Department of Public Health, and others, creating a holistic and strategic approach to improving maternity care practices which together support optimal breastfeeding outcomes. We present a qualitative analysis of state level change.  The collaborative itself is funded only by state breastfeeding coalition, and provides volunteer faculty, food for meetings, and webpage hosting and runs with minimal expense.

Results: Every hospital in the state is now participating in at least one of these efforts, and most are participating in more than one. Massachusetts now has 6 Baby-Friendly facilities with 18 more officially on the pathway, and 82% are participating in the Baby-Friendly Collaborative. The Collaborative, DPH, the Mother-Baby Summit, and others together provide networking and shared resources and technical assistance to help all hospitals implement evidence-based maternity care practices.

Conclusions: A multipronged approach including a Collaborative can inspire and sustain change on a state level and some efforts can go far with minimal resources.