Find State ESMs

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: Mixed. Aligns with MCHbest strategy "Hospital Policies". 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 certification program as documented by Baby Steps to Breeastfeeding Success (AZ) program in AMCHP's 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 related to systems-building

Goal: Increase by 5% the number of infants exclusively breastfed through 6 months by 2025.

Numerator: Number of birthing hospitals who are implementing all 10 steps to successful breastfeeding

Denominator:

Significance: Promotion of 10 steps to successful breastfeeding to KY birthing hospitals, with policy/systems level engagement by the birthing providers during hospitalization and after discharge helps improve initiation and duration of breastfeeding.

Data Sources and Data Issues: MCH Breastfeeding Program Data Reports (Nutrition Services Branch)

Year: 2023

Unit Type: Count, Unit Number: 48

Evidence Level: Emerging. Aligns with MCHbest strategy "Family Leave, Workplace Policies, State Laws". Find other NPM 4 workplace-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Emerging Practice. Aligns with workplace-level strategy as documented by the Communities Supporting Breastfeeding program in AMCHP's Innovation Hub.

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

Service Type: Enabling services level of pyramid

Essential Public Health Services: 5. Create/champion/implement policy

Service Recipient: Activities directed to professionals

Goal: To increase the percent of infants who are breastfed and who are breastfed exclusively through six months.

Numerator: Number of businesses who receive information and technical assistance on workplace breastfeeding policies.

Denominator:

Significance: Number of businesses who receive information and technical assistance on workplace breastfeeding policies. This ESM will provide an indicator of the number of workplaces across the state who have been contacted regarding the Infant Friendly Workplace designation. This can help us track how efforts to provide education translate into workplaces implementing a policy and becoming designated as Infant Friendly. The Infant Friendly Workplace designation recognizes employers who implement breastfeeding support policies addressing adequate break time; a clean, private location for milk expression; and available resources for clean water and breast milk storage for employees. By providing technical assistance and education to employers about how to implement a breastfeeding support policy, more women will be supported at work and breastfeed longer, thereby increasing the percentage of infants who are breastfed exclusively for 6 months, NPM 4b.

Data Sources and Data Issues: North Dakota Department of Health. Family Health and Nutrition Program.

Year: 2023

Unit Type: Count, Unit Number: 200

Evidence Level: Emerging. Aligns with MCHbest strategy "Family Leave, Workplace Policies, State Laws". Find other NPM 4 workplace-level strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Emerging Practice. Aligns with workplace-level strategy as documented by the Communities Supporting Breastfeeding program in AMCHP's 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: 5. Create/champion/implement policy

Service Recipient: Activities related to systems-building

Goal: To increase the percent of infants who are breastfed and who are breastfed exclusively through six months.

Numerator: Number of businesses designated Infant Friendly Workplaces.

Denominator:

Significance: Number of businesses designated Infant Friendly Workplaces. This ESM will provide the number of workplaces across the state who have implemented a policy and became designated as an Infant Friendly Workplace. The Infant Friendly Workplace designation recognizes employers who implement breastfeeding support policies addressing adequate break time; a clean, private location for milk expression; and available resources for clean water and breast milk storage for employees. By providing technical assistance and education to employers about how to implement a breastfeeding support policy, more women will be supported at work and breastfeed longer, thereby increasing the percentage of infants who are breastfed exclusively for 6 months, NPM 4b.

Data Sources and Data Issues: The Center for Disease Control and Prevention’s (CDC) Guide to Strategies to Support Breastfeeding Mothers and Babies lists intentions to work full-time are associated with lower rates of breastfeeding initiation and shorter duration. The CDC’s Implementation Guide for the Notice of Funding Opportunity: State Physical Activity and Nutrition Program lists evidence demonstrates supportive policies and programs at the workplace enable women to continue providing breast milk for their infants for significant periods after they return to work. The Infant Friendly Workplace designation recognizes employers who implement breastfeeding support policies addressing adequate break time; a clean, private location for milk expression; and available resources for clean water and breast milk storage for employees. By providing technical assistance and education to employers about how to implement a breastfeeding support policy, more women will be supported at work and breastfeed longer, thereby increasing the percentage of infants who are breastfed exclusively for 6 months, NPM 4b. By September 30, 2025, increase the number of businesses designated as Infant Friendly Workplaces from 133 to 200. North Dakota Department of Health. Family Health and Nutrition Program.

Year: 2023

Unit Type: Count, Unit Number: 200

Evidence Level: Emerging. Aligns with Provider Education. Find other NPM 4 strategies in MCHbest.

Alignment with field-based evidence through Innovation Hub: Promising Practice. Aligns with Provider Education in Breastfeeding as documented by the Birth and Beyond program in AMCHP's Innovation Hub. Emerging Practice. Aligns with Provider Education in Breastfeeding as documented by the Baby Steps to Breastfeeding Success program in AMCHP's Innovation Hub. Emerging Practice. Aligns with Provider Education in Breastfeeding as documented in the BreastfeedingTraining.org program in AMCHP's Innovation Hub. Promising Practice. Aligns with Provider Education in Breastfeeding as documented by the On-Demand Telesimulation in Maternal-Newborn Care and Clinical Lacation 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: 8. Build and support a workforce

Service Recipient: Activities directed to professionals

Goal: To provide technical assistance to local grantees that leads to an increase in breastfeeding.

Numerator: Number of local grantees that report improvements following state technical assistance

Denominator: Number of local grantees that selected breastfeeding as a priority

Significance: A crucial component of state level efforts to increase breastfeeding rates is to support local grantees, by providing technical assistance and resources.

Data Sources and Data Issues: Local grantee reports

Year: 2023

Unit Type: Percentage, Unit Number: 100