Evidence-Based Hospital Practices

Hospital Practices Effect Breastfeeding

It is well documented that breastfeeding provides the best start in life for a new baby and has multiple benefits to mother, family, and society at large. Hospital maternity care practices are critical to breastfeeding success. Support provided in the initial post-partum period has been found to impact breastfeeding success weeks and even months later.

Note:  See also BCO webpage Research & Resource Library

CDC Resources, including the mPINC Survey

The Centers for Disease Control & Prevention (CDC) recognizes the crucial role of hospitals.

To improve maternity care practices related to breastfeeding across the US, CDC created a national survey of hospital facilities entitled mPINC (Maternity Practices in Infant Nutrition and Care). Every participating facility receives a confidential report providing feedback on how their practices compare to other facilities in their area.  The CDC publishes aggregate state data from the mPINC reports, that does not call out individual facility practices.


The Joint Commission

The Joint Commission is the accrediting body for hospitals and health systems.  In 2010, they issued a new Perinatal Care Core Measure Set that included exclusive breast milk feeding.  The United States Breastfeeding Committee published a detailed Guide to Implementation of these measures.

WHO/UNICEF Ten Steps To Successful Breastfeeding

The World Health Organization and UNICEF outlined Ten Steps to Successful Breastfeeding, a checklist of evidence-based hospital practices that, when implemented, positively impact breastfeeding success.  The more Steps a mother experiences, the greater her likelihood of leaving the hospital exclusively breastfeeding, and the more likely her breastfeeding duration and intensity after discharge.

Oregon Hospitals Partnering for Evidence-Based Infant Nutrition (OEBIN)

The Breastfeeding Coalition of Oregon (BCO) is engaged in a statewide project to support Oregon hospitals in improving their maternity care practices related to breastfeeding. We utilize our state’s mPINC scores, as well as hospital self-assessments, to provide facility-specific technical assistance and encouragement for hospitals around the state to use evidence-based practices regarding infant nutrition. Together, we are forming an ongoing learning community to support this momentum across the state.  Funding for this project is provided by Multnomah County Health Department and Oregon WIC.

In May, 2011, BCO hosted an inaugural statewide summit that was co-sponsored by Oregon Public Health Institute (OPHI) and the Oregon Association of Hospitals and Health Systems (OAHHS).   Administrators and physicians from 35 Oregon birth facilities came together for a day-long conversation facilitated by Carol Melcher.

With the support of OAHHS, we will be hosting ongoing webinars to support the work of an OEBIN learning community.  The first webinar will be sharing from Oregon’s newest Baby-Friendly hospital, Providence Newberg, about lessons learned on their journey to certification.  This will be held in early December (date TBA) and a follow-up conference will be held March 2-3 in Portland.

Oregon Baby-Friendly Hospitals

The Breastfeeding Coalition of Oregon is proud to support and celebrate the five Oregon hospitals which have achieved the WHO/UNICEF designation of Baby-Friendly

They are:

  • PeaceHealth Nurse Midwifery Birth Center, Eugene (1997)
  • Three Rivers Community Hospital, Grants Pass (1999)
  • Kaiser Sunnyside Medical Center, Clackamas (2000)
  • Providence Medford Medical Center, Medford (2000)
  • Providence Newberg Medical Center, Newberg (2011)
  • We also recognize the pioneering work of Cottage Grove Community Hospital, the first healthcare system in the United States to become Baby-Friendly, in 1997.  This facility has since closed.

Oregon hospitals on the Baby-Friendly 4D Pathway

The Breastfeeding Coalition of Oregon applauds the facilities that have formally entered the Baby-Friendly USA pathway to certification, by submitting an initial self-assessment, as well as Letter of Intent signed by the CEO.  The following hospitals are formally engaged in this work:

  • McKenzie-Willamette Medical Center, Eugene
  • Oregon Health & Sciences University, Portland
  • Providence Seaside Medical Center, Seaside
  • Sacred Heart Medical Center, Eugene

More information about the Baby-Friendly Hospital Initiative

From the Baby-Friendly USA website:

  • The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Childrens Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for lactation.  Baby-Friendly USA is the organization that guides and designates hospitals in the United State.
  • Baby-Friendly USA uses a 4-D Pathway to assist hospitals in their journey through the Ten Steps to Successful Breastfeeding, the evidence-based standard of care that increases breastfeeding success.
  • The more BFHI “Steps” a mother experiences, the higher her likelihood of reaching her breastfeeding goals.  Three out of four US mothers initiate breastfeeding, but this number falls off dramatically if she’s not supported in the early days of her breastfeeding experience.