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Evidence Level: Mixed. Aligns with MCHbest strategy "Hospital Policies" (https://www.mchevidence.org/tools/strategies/4-6.php). Find other NPM 4 hospital-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Emerging. Aligns with Hospital perinatal health quality improvement and staff training demonstration project as documented by the Baby Steps to Breastfeeding Success (AZ) program in AMCHP's Innovation Hub.

Measurement Quadrant: Quadrant 4: Measuring quality of effect (% of "is anyone better off")

Service Type: Systems level of pyramid

Essential Public Health Services: 6. Utilize legal and regulatory actions

Service Recipient: Activities directed to families/children/youth

Goal: Increase the proportion of births that occur at Breastfeeding-Friendly Maternity Centers

Numerator: Number of live births that occurred at currently accredited MDH Breastfeeding-Friendly Maternity Centers

Denominator: Number of live births in calendar year

Significance: Most births in Minnesota occur in hospital settings. Maternity hospital practices and policies can undermine maternal and infant health by creating barriers to supporting a mother's decision to breastfeed. When hospitals implement the Baby-Friendly Ten Steps, they have the tools to give mothers the information, confidence, and skills necessary to successfully initiate and continue to breastfeed their babies. Women who get the support they need in the hospital are much more likely to continue once they return home. MDH’s Breastfeeding-Friendly Maternity Center Five-Star program tracks progress by hospitals in implementing evidence-based processes, provides technical assistance to hospitals applying for Stars, and provides intermediate recognition of work on the Ten Steps, without the costs associated with Baby-Friendly designation, which are a barrier to hospitals achieving BFHI designation. MDH’s program is intended to encourage hospitals to move toward BFHI designation. Hospitals can achieve designation are accredited for 3 years, or, in conjunction with Baby-Friendly USA designation, for 5 years. Each two Steps implemented earns one Star, for a possible total of Five Stars/Ten Steps achieved.

Data Sources and Data Issues: Data Source: MN Vital Records and MDH’s Accreditation Database, tracked in Redcap. Accreditation process monitored by WIC breastfeeding unit staff and OSHII staff. Achievement of individual Steps is applied for and progress documented by hospital staff, with completed Steps reviewed and verified by MDH staff and partners from the Minnesota Breastfeeding Coalition. Limitations of Data: The expiration of accreditation is tied to completion of the 10th Step and other Steps may have been completed longer than 3/5 years prior. MN Vital Records are limited to births that occur to Minnesota Residents in Minnesota.

Year: 2023

Unit Type: Percentage, Unit Number: 100

Evidence Level: Emerging. Aligns with MCHbest strategy "Provider Training". Find other NPM 4 provider-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: No similar strategies found in Innovation Hub.

Measurement Quadrant: Quadrant 1: Measuring quantity of effort (counts and "yes/no" activities)

Service Type: Systems level of pyramid

Essential Public Health Services: 8. Build and support a workforce

Service Recipient: Activities directed to families/children/youth

Goal: Increase the number of Idahoans who receive information about best practices related to breastfeeding through attendance at the annual Idaho Breastfeeeding Summit.

Numerator: Number of professionals and parents who attend annual Idaho Breastfeeding Summit.

Denominator:

Significance: The MCH leadership team will support an annual statewide breastfeeding summit to provide healthcare providers training on best practices for breastfeeding initiation and duration. The Kansas Breastfeeding Coalition (KBC), established the Community Supporting Breastfeeding (CBS) program, which incorporates varied approaches that assist breastfeeding mothers, promote initiation and duration of breastfeeding by including the formation of a local breastfeeding coalition, offering a course for healthcare providers to learn about supporting breastfeeding, and provide resources and information to reduce barriers and increase the perception of breastfeeding (Association of Maternal & Child Health Programs [AMCHP], 2016). Program participants indicated that the coalition cultivated engagement, leadership development, and community support, as well as increased involvement from organizations and government officials that support and advocate towards breastfeeding by enhancing the sustainability and engagement of existing programs, and allocating breastfeeding coalitions in areas where they are not provided (AMCHP, 2016). Additionally, Colorado has had success in increasing breastfeeding rates through statewide training of hospital personnel and informing parents about beneficial breastfeeding practices through Local Public Health agencies such as Women, Infants and Children (WIC) (AMCHP, 2012). Colorado experienced notable increases in breastfeeding initiation and duration rates following the five-key breastfeeding strategy, Colorado Can Do 5, which offers five beneficial breastfeeding practices to hospitals and medical centers (Colorado Department of Public Health and Environment, 2011).

Data Sources and Data Issues: Idaho Breastfeeding Coalition

Year: 2023

Unit Type: Count, Unit Number: 1,000