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Strengthening the evidence for maternal and child health programs

Find State ESMs


Displaying records 1 through 20 (81 total).

4.1 The proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies. (California)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies.

Numerator: Number of live births that occur in hospitals and birth centers designated as Baby-Friendly (as of December 31).

Denominator: Number of live births that occur in hospitals or birth centers.

Significance: Hospital practices significantly affect whether a woman chooses to start breastfeeding and how long she continues to breastfeed. The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for lactation based on the WHO/UNICEF Ten Steps to Successful Breastfeeding for Hospitals. To be designated as “Baby-Friendly,” facilities undergo external evaluation to demonstrate that the facility meets all ten of the recommended elements of care. All types and sizes of birth facilities can seek the Baby-Friendly designation. Because birth facilities vary in size and the number of annual births, measuring the effect of their maternity care and practices on public health requires more than just counting the number of Baby-Friendly facilities per state. Thus, the public health impact is assessed by using the proportion of annual live births in the U.S. that occurred at facilities that have earned the Baby-Friendly designation. As of 2015, there were 79 hospitals (out of approximately 250) designated as Baby-Friendly in California. Recent legislation requires that all California hospitals that have a perinatal unit adopt the BFHI “Ten Steps to Successful Breastfeeding” or an alternate process by January 1, 2025.

Data Sources and Data Issues: Birth Statistical Master file

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 The percentage of births occurring in Oklahoma birthing hospitals designated as Baby-Friendly (Oklahoma)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: Increase the number of Oklahoma birthing hospitals that are Baby-Friendly

Numerator: The number of births occurring at Baby-Friendly hospitals

Denominator: The number of resident live births

Significance: Breastfeeding, specifically exclusive breastfeeding, is known to provide immediate benefits to infants and mothers and long-term protection from chronic health problems that lead to morbidity and mortality. Achieving the Baby-Friendly designation is an evidence based practice that has been shown to increase breastfeeding initiation and duration. Guidelines and Evaluation Criteria for Facilities Seeking Baby-Friendly Designation. 2016 revision. Baby-Friendly USA, Inc.

Data Sources and Data Issues: Vital Statistics Data, Health Care Information, Center for Health Statistics, Oklahoma State Department of Health and Baby-Friendly USA

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 The percent of Puerto Rico Home Visiting Program (HVP) participants who ever breastfed by September 2017-2021 (ongoing) (Puerto Rico)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: At least 81.7% Puerto Rico Home Visiting Program participants report ever breastfed by September 2017 (ongoing).

Numerator: The number HVP participants report ever breastfed.

Denominator: The number HVP participants.

Significance: Mothers who receive post-partum breastfeeding support are more likely to continue to breastfeed beyond the neonatal period. Because increase in the number of mothers breastfeeding is one of the aims of the MCAH program, the HVN will promote and offer breastfeeding education and support to all participants. The efforts will be monitored by the number of mothers who achieve the goal of breastfeeding successfully. This monitoring is important to evaluate the success of the interventions and propose modifications to the strategies.

Data Sources and Data Issues: HVP Program Reports.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 The number of health providers participating in certified lactation counselors training who are minority women. (Nebraska)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to professionals

Goal: Increase the number minority representation in consulting in order to increase the diversity of women who successfully breastfeed.

Numerator: NA

Denominator: NA

Significance: Breastfeeding is beneficial to almost all mothers and infants, but the benefits may be significantly greater for minority women. Minority women are disproportionately affected by adverse health outcomes, which may improve with breastfeeding. Relative to white women in the United States, African American and Hispanic women have increased rates of obesity, diabetes, and cardiovascular disease. Research suggests that breastfeeding may reduce a mother's risk of hypertension, hyperlipidemia, and cardiovascular disease.

Data Sources and Data Issues: Program data.

Year: 2018/2020

Unit Type: Count, Unit Number: 15

4.1 Stepping Up for Utah Babies: Number of Utah hospitals, that deliver babies, that have implemented some of WHO's evidence based 10 Steps to Breastfeeding Success (Utah)

Measure Status: Active

Measurement Category: Category 3: measuring quantity of effect (# of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: Increase the number steps being implemented in Utah delivering hospitals.

Numerator: Number of steps implemented

Denominator: N/A (Number of steps implemented)

Significance: Advantages of breastfeeding are indisputable. The American Academy of Pediatrics recommends all infants (including premature and sick newborns) exclusively breastfeed for about six months as human milk supports optimal growth and development by providing all required nutrients during that time. Breastfeeding strengthens the immune system, improves normal immune response to certain vaccines, offers possible protection from allergies, and reduces probability of SIDS. Research demonstrates breastfed children may be less likely to develop juvenile diabetes; and may have a lower risk of developing childhood obesity, and asthma; and tend to have fewer dental cavities throughout life. The bond of a nursing mother and child is stronger than any other human contact. A woman's ability to meet her child’s nutritional needs improves confidence and bonding with the baby and reduces feelings of anxiety and post natal depression. Increased release of oxytocin while breastfeeding, leads to a reduction in post-partum hemorrhage and quicker return to a normal sized uterus over time, mothers who breastfeed may be less likely to develop breast, uterine and ovarian cancer and have a reduced risk of developing osteoporosis.

Data Sources and Data Issues: Program level data

Year: 2018/2020

Unit Type: Count, Unit Number: 999

4.1 Percentage of mothers who report a baby-friendly experience at a New Mexico birthing facility (New Mexico)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of birth facilities that have achieved baby-friendly status

Numerator: Number of PRAMS respondent mothers who report experiencing 8 baby friendly steps at the hospital where they gave birth

Denominator: Number of PRAMS respondent mothers who gave birth at a birthing facility and started breastfeeding

Significance: The advantages of breastfeeding are indisputable, and Baby-Friendly hospitals provide an opportunity and for mothers to initiate breastfeeding by encouraging and recognizing hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It designates birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding and the International Code of Marketing of Breast-milk Substitutes. The New Mexico PRAMS survey includes 8 questions that correspond to baby friendly experience, so this ESM will allow New Mexico to assess the mother's self-reported experience with the percentage of births at baby friendly facilities thereby utilizing PRAMS to measure the correspondence between self-reported baby-friendly experience and the number of births in New Mexico.

Data Sources and Data Issues: The New Mexico Pregnancy Risk Assessment Monitoring System (PRAMS)

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percentage of MIECHV home visiting staff who received education about best-practices for supporting breastfeeding among new mothers (Idaho)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to professionals

Goal: The MCH Program, in collaboration with the MIECHV and WIC Programs, will fund and host one meeting for home visitors focused on evidence-based strategies for providing breastfeeding education and support to new mothers.

Numerator: Percentage of MIECHV home visiting staff who received education about best-practices for supporting breastfeeding among new mothers

Denominator: Total number of MIECHV home visiting staff

Significance: According to the Centers for Disease Control's 2016 Breastfeeding Report Card, 92.9% of Idaho infants are reported to have ever been breastfed, yet only 28.1% are reported to have been exclusively breastfed through 6 months. The MIECHV program currently serves pregnant women and new mothers. According to the Association of Maternal and Child Health Programs, other states have realized success in increasing breastfeeding duration rates in home visiting programs when home visitors are trained on best practices for supporting breastfeeding moms. Other research (Hannula et al., 2008 and Oliveira et al., 2001) shows that home visits during the postnatal period were effective for addressing mothers’ concerns about breastfeeding, providing education, linking them with community resources, and involving other family members. For FY2017, the Idaho MCH Program plans on collaborating with the MIECHV Program to fund training for home visitors, which will be facilitated by WIC staff, on breastfeeding education, how to answer mother’s questions regarding breastfeeding, how to encourage fathers to support breastfeeding, and how to link families with community resources.

Data Sources and Data Issues: The MCH leadership team and BSU evaluation team will collect the number of home visitors who participated in the training. Attendance will be based on sign-in sheets or online logins (if the training is hosted remotely).

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percentage of eligible facilities certified “Breastfeeding Friendly Washington” by Washington Department of Health (DOH) (Washington)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: Track the certification of eligible facilities by DOH as Breastfeeding Friendly Washington

Numerator: Number of eligible facilities which have adopted Breastfeeding Friendly Washington

Denominator: Total number of eligible facilities

Significance: Breastfeeding has been shown to be extremely beneficial for both the mother and infant. The initiation of breastfeeding and its maintenance for as long as possible has been one of OHC’s core recommended practices. An increase in this measure will help to assure that new mothers are introduced to the practice with the greatest amount of support to achieve the longest maintenance of the behavior. In the long run, this will lead to healthier mothers and healthier infants.

Data Sources and Data Issues: Data would come from eligible facilities reporting that they are compliant with the program and have obtained their certification. These data are reported to OHC presently. One potential issue is inconsistencies in co-sleeping practice recommendations between the certification for Breastfeeding Friendly and the “Cribs for Kids” program of which DOH is considering adoption for its “back to sleep” ESM.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of Women, Infants, and Children (WIC) infants ever breastfed (Hawaii)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Promote Breastfeeding in all WIC clinics statewide

Numerator: Unduplicated number of WIC infants ever breastfed by SFY

Denominator: Unduplicated number of WIC infants by SFY

Significance: Breastfeeding is the normative standard for infant feeding and nutrition and can result in improved infant and maternal health outcomes. Given the indisputable short- and long-term advantages of breastfeeding, infant nutrition is considered a public health priority. The American Academy of Pediatrics (AAP) recommends that all infants be exclusively breastfed for about six months with continuation of breastfeeding for one year or longer. Breastfeeding is also encouraged and supported by other agencies such as the United States Department of Agriculture’s (USDA) Food and Nutrition Service (FNS). However, as rewarding as breastfeeding can be, some women choose not to breastfeed and many women who start breastfeeding often stop when they are faced with challenges. With appropriate guidance and education, women can overcome these obstacles and continue breastfeeding for longer periods. WIC is the largest public breastfeeding promotion program in the state and nation, providing mothers with education and support as a core service. Moreover, promoting and/or facilitating community activities that reinforce breastfeeding may allow for more women across the state to have access to the support they need to initiate breastfeeding and continue doing so exclusively for at least 6 months.

Data Sources and Data Issues: Hawaii WIC Program Data

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of women provided with in-person or telephonic breastfeeding consults/support services (District of Columbia)

Measure Status: Active

Measurement Category: Category 1: measuring quantity of effort (counts and "yes/no" activities)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of infants breastfed up to six months and increased the percent of infants exclusively breastfed. Provide technical assistance to maternity facilities to achieve the 4-D Pathway to Baby-Friendly designation.

Numerator: Number of women provided with in-person or telephonic breastfeeding consults/support services

Denominator: N/A

Significance: The 2014 Breastfeeding Report Card reports 77.6% of infants in the District of Columbia initially breastfed. Breastfeeding rates drop dramatically by six months (53%) and twelve months (30%). Only 17% of women in the District are exclusively breastfeeding at six months. In DC, the breastfeeding initiation rates can be as low as 36% at WIC clinics in predominantly African American areas of the city. WIC breastfeeding initiation rates DC wide are lower than the District average at 59% for fiscal year 2015.

Data Sources and Data Issues: 1. District of Columbia Breastfeeding Coalition (DCBFC) 2. Healthy Start

Year: 2018/2020

Unit Type: Count, Unit Number: 1,000,000

4.1 Percent of women educated on the importance of breastfeeding to ensure that the feeding decision is fully-informed. (Iowa)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Middle level: enabling services

Service Recipient: Activities directed to families/children/youth

Goal: Increase knowledge of importance of breastfeeding to ensure that the feeding decision is fully-informed.

Numerator: Number of maternal health clients who receive education on breastfeeding.

Denominator: Total number of women who receive direct or enabling services from a MH agency

Significance: Education of the importance of breastfeeding has been shown to increase the initiation and continuation of breastfeeding in mothers.

Data Sources and Data Issues: Data field will need to be added to WHIS to capture if maternal health clients received breastfeeding education.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of WIC infants breastfed exclusively through six months in designated Communities Supporting Breastfeeding (Kansas)

Measure Status: Active

Measurement Category: Category 4: measuring quality of effect (% of "is anyone better off")

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the number of WIC infants breastfed exclusively through six months of age, in communities defined as either a city or county, that have been designated as a “Community Supporting Breastfeeding” by the Kansas Breastfeeding Coalition, Inc.

Numerator: Number of WIC infants breastfed exclusively through six months in communities that have reached the designation of a “Community Supporting Breastfeeding”

Denominator: Number of WIC infants in communities that have reached the designation of a Community Supporting Breastfeeding

Significance: Human milk is the preferred feeding for all infants, including premature and sick newborns. Exclusive breastfeeding is ideal nutrition and sufficient to support optimal grown and development for approximately the first 6 months after birth. The advantages of breastfeeding are indisputable and include nutritional, immunological and psychological benefits to both mother and infant, as well as economic benefits. If mothers get the support they need in the first 4 weeks of a new baby’s life, they are more likely to keep breastfeeding. Mothers may need help finding people who are trained to assist with breastfeeding after they leave the hospital. Without help, some mothers may stop breastfeeding. Communities often provide a number of resources and programs to help breastfeeding mothers. The Surgeon General recommends programs which provide mother-to-mother support and peer counseling, use a variety of media venues to reach young women and their families, and the expansion of the use of programs in the workplace that allow lactating mothers to have direct access to their babies.

Data Sources and Data Issues: Kansas WIC Data System (KWIC)

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of local health departments who have had Maternal Health staff members trained on BF promotion and support through the NC Regional Lactation Training Centers (North Carolina)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: To increase the amount of breastfeeding promotion and support provided to women receiving maternal health care in local health departments

Numerator: Number of local health departments who have had Maternal Health staff members trained on BF promotion and support through the NC Regional Lactation Training Centers

Denominator: Number of local health departments who provide prenatal direct services (80)

Significance: Exclusive breastfeeding is considered one of the most effective preventive health measures to reduce child morbidity and mortality, in the US and globally. Health practitioners play a key role in providing support to breastfeeding women.

Data Sources and Data Issues: The State Breastfeeding Peer Counselor Coordinator will provide a baseline count of local health departments with Maternal Health staff who have received training as of July 1, 2015 and then update this count annually. She will obtain this data from the work plans provided by the Regional Lactation Training Consultants.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of live births occurring in Baby-Friendly hospitals (Illinois)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: To increase the percent of births occurring in hospitals providing optimal lactation support

Numerator: # live births in Baby-Friendly Hospitals

Denominator: # live births in Illinois Hospitals

Significance: Lactation support and breastfeeding-friendly policies are essentially components for helping new mothers initiate and maintain breastfeeding. The Baby-Friendly Initiative is a process that certifies hospital facilities as having the necessaries policies and supports in place to promote breastfeeding for all infants. For many years, only a handful of the approximately 120 Illinois birthing hospitals were Baby-Friendly, but increased encouragement for hospitals to pursue this designation over the last 5-10 years has slowly begun to expand the number of Baby-Friendly hospitals in the state. Prior to 2015, there were only 4 Baby-Friendly hospitals in Illinois. The number of additional hospitals that were designated as Baby-Friendly in the following years were: 3 in 2015, 8 in 2016, 4 in 2017, and 5 in 2018 (as of July). The total number of Illinois Baby-Friendly Hospitals now stands at 24, and additional hospitals are in the middle of completing the designation process. The full list of Baby-Friendly hospitals in Illinois is available at: https://www.babyfriendlyusa.org/find-facilities/designated-facilities--by-state. This measure will track the percent of Illinois live births occurring in Baby-Friendly hospitals over time. It is related to Healthy People 2020 objective MICH-24: Increase the proportion of live births that occur in facilities that provide recommended care for lactating mothers and their babies. (Measure added July 2018 when NPM #4 was added to Illinois' selections)

Data Sources and Data Issues: CDC Breastfeeding Report Card, Baby-Friendly USA

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of hospitals (birthing facilities) receiving training on Baby Steps to Breastfeeding Success or designated as Baby Friendly by Baby Friendly USA (Nevada)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: To increase the number of hospitals (birthing facilities) receiving training on Baby Steps to Breastfeeding Success or designated as Baby Friendly by Baby Friendly USA.

Numerator: Number of hospitals (birthing facilities) receiving training on Baby Steps to Breastfeeding Success or designated as Baby Friendly by Baby Friendly USA.

Denominator: Number of birthing facilities in Nevada (19)

Significance: Birth facilities that have achieved Baby Friendly designation typically experience an increase in breastfeeding rates. Research has found a relationship between the number of Baby Friendly steps (included in the Ten Steps to Successful Breastfeeding) in place at a birth facility and a mother’s breastfeeding success. In addition, mothers experiencing none of the Ten Steps to Successful Breastfeeding during their stay were eight times as likely to stop breastfeeding before 6 weeks compared to those experiencing five out of the ten steps. These findings emphasize the value of having hospitals acquire Baby Friendly designation.

Data Sources and Data Issues: Data Source: Nevada Statewide Breastfeeding Program.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of facilities designated as a Keystone 10 facility each fiscal year. (Pennsylvania)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: To increase the number of facilities becoming Keystone 10 designated.

Numerator: Number of facilities enrolled in initiative which are Keystone 10 designated each fiscal year.

Denominator: Number of facilities enrolled in initiative at the beginning of the fiscal year.

Significance: The Breastfeeding Awareness and Support Program is currently funding an initiative called the Keystone 10 Initiative within Pennsylvania birthing facilities. The goal of this initiative is to facilitate the adoption and implementation of ten evidence-based steps, commonly known as the Ten Steps to Baby Friendly Hospitals. Evidence demonstrates that breastfeeding rates at facilities increase as those facilities implement the evidence based steps. Monitoring the increase in the number of facilities completing all steps and becoming Keystone 10 designated will ensure movement by these facilities towards increasing breastfeeding rates.

Data Sources and Data Issues: Data for the numerator will be gleaned both from the vendor reports as well as from the DOH website on which the listing of hospitals achieving steps is provided. The denominator is the total number of facilities enrolled in the initiative at the beginning of the fiscal year. The denominator will change as new facilities are added to the initiative (funding dependent).

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of eligible WIC participants who receive counseling services from a breastfeeding Peer Counselor (Massachusetts)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities directed to families/children/youth

Goal: Expand the breastfeeding support that women receive to help extend the duration of breastfeeding

Numerator: Number of WIC women who are eligible for breastfeeding counselor support who receive breastfeeding counselor services

Denominator: Number of WIC women who are eligible for breastfeeding counselor support

Significance: According to the Surgeon General’s Call to Action to Support Breastfeeding “one of the most highly effective preventive measures a mother can take to protect the health of her infant and herself is to breastfeed. However, in the U.S., while 75% of mothers start out breastfeeding, only 13 percent of babies are exclusively breastfed at the end of six months…A mother’s ability to begin and to continue breastfeeding can be influenced by a host of community factors… programs such as the U.S. Department of Agriculture’s WIC program can expand the support that women ideally have received in the hospital and help extend the duration of breastfeeding.” This ESM will help track the support that WIC participants receive for breastfeeding. This ESM is supported by the findings of Chapman and Perez-Escamilla (2012) which found that peer counseling interventions greatly improved breastfeeding initiation, duration or exclusivity. (http://dx.doi.org/10.3945/an.111.001016) Chapman et al (2010) also found that breastfeeding incidence increased significantly more among mothers attending WIC clinics offering breastfeeding peer counselors. (http://dx.doi.org/10.1177/0890334410369481)

Data Sources and Data Issues: Massachusetts WIC data

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of birthing hospitals receiving recognition from Ohio First Steps for Healthy Babies (Ohio)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: By tracking the percentage of hospitals receiving this recognition, we are able to measure our progress/success in obtaining buy-in from hospitals on fostering a breastfeeding friendly environment.

Numerator: Number of Ohio hospitals who are recognized by the Ohio First Steps for Healthy Babies initiative.

Denominator: Number of Ohio birthing hospitals

Significance: This measure is significant because it tracks overall hospital participation as well as the individual progress hospitals are making towards the Ten Steps to Successful Breastfeeding. When hospitals have more of the Ten Steps in place, mothers breastfeed longer. The goal of the First Steps initiative is to encourage and support hospitals to implement the Ten Steps to Successful Breastfeeding and become a Baby-Friendly USA designated hospital. Mothers who give birth at Baby-Friendly hospitals are more likely to initiate exclusive breastfeeding and more likely to sustain breastfeeding at six months and one year of age.

Data Sources and Data Issues: The source of the data will be from the Ohio First Steps for Healthy Babies review committee and their data tracking sheet. Limitations are that data are self-reported by the hospitals and some of the objectives can be based on estimates instead of chart reviews and patient interviews. The First Steps for Healthy Babies is a voluntary initiative—not all of Ohio’s birthing hospitals participate.

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of Baby-Friendly designated birthing hospitals in Michigan (Michigan)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: By increasing the number of Michigan birthing hospitals with Baby-Friendly designation, the proportion of live births that occur in Michigan birthing hospitals that provide recommended care for lactating mothers and their babies will increase

Numerator: Number of Michigan birthing hospitals with Baby-Friendly designation

Denominator: Number of Michigan birthing hospitals

Significance: Baby-Friendly designated birthing hospitals and centers 1) promote breastfeeding as the best method of infant feeding; 2) implement evidence-based practices to support breastfeeding and lactation; 3) facilitate informed health care decision-making for mothers and families; 4) ensure health care delivery that is sensitive to cultural and social diversity, 5) protect mothers and families from false or misleading product promotion and advertising, and 6) educate parents on safe and appropriate methods for formula mixing, handling, storage, and feeding when a mother has chosen not to breastfeed or has chosen to supplement. The Baby-Friendly Hospital Initiative is a global program launched by the World Health Organization and the United Nations Children’s Fund in 1991 to encourage and recognize hospitals and birthing centers that provide the best level of care for infant feeding and mother/baby bonding. Baby-Friendly designation is built on the implementation of Ten Steps to Successful Breastfeeding and the International Code of Marketing of Breast-Milk Substitutes, which empowers birthing facilities to examine maternity care policies and procedures, requires training and skill building for all levels of staff, and involves the development of quality assurance mechanisms within all aspects of maternity care operations. Baby-Friendly designated birthing hospitals and centers support healthy outcomes for both baby and mom, and can help to reduce breastfeeding disparities, especially within communities of color and low socioeconomic status communities.

Data Sources and Data Issues: Baby-Friendly USA, Inc. (BFUSA)

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

4.1 Percent of Arkansas birthing hospitals aware of the ADH Baby Friendly Hospital Toolkit (Arkansas)

Measure Status: Active

Measurement Category: Category 2: Measuring quality of effort (% of reach; satisfaction)

Service Type: Bottom level: public health services and systems

Service Recipient: Activities related to systems-building

Goal: To increase awareness of the ADH Baby Friendly Hospital Toolkit among Arkansas birthing hospitals

Numerator: Number of Arkansas birthing hospitals educated about purpose and use of the Baby Friendly Hospital Toolkit

Denominator: Number of Arkansas birthing hospitals

Significance: Despite the wealth of information about the benefits of breastfeeding, Arkansas's rates consistently lag behind national rates and Healthy People 2020 goals. In order to improve breastfeeding initiation and maintenance rates, the ADH developed a hospital-focused toolkit that includes important information for expectant mothers to learn in the prenatal period as well as breastfeeding support literature and information about storage and handling of breast milk, hunger cues, skin-to-skin care. The toolkit also includes example policies and position statements as well as literature from the field.

Data Sources and Data Issues: Program information

Year: 2018/2020

Unit Type: Percentage, Unit Number: 100

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.