1.  Breastfeeding Curriculum Megan Mariner MD LATCH NOW

2. Course schedule  Chapter 1: Introduction  Chapter 2: Why Breastfeed  Chapter 3: Talking with Patients  Chapter 4: Anatomy and Physiology  Chapter 5: Early Breastfeeding  Chapter 6: Latching On  Chapter 7: Pumping and Storage  Chapter 8: Assessing Milk Supply  Chapter 9: Trouble Shooting  Chapter 10: Conclusion

3. Pretest  Anonymous  Used for quality improvement

4.  The 10 Steps Program Becoming a Baby Friendly Hospital

5. Goals and Objectives  Explain what it means to be a “Baby Friendly Hospital”.  Name 3 of the 10 steps to Baby Friendly status.

6. The WHO and UNICEF  International nonprofit organizations  Numerous health policies and programs  Committees for each topic  Joint breastfeeding and infant nutrition policy

7. The WHO and UNICEF  “Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy growth and development. Virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large.”

8. The Baby Friendly Hospital Initiative  Recognizes hospitals with best practices  93 US hospitals  20,000 internationally  “The 10 Steps to Successful Breastfeeding”

9. The 10 Steps: Step 1  Have a written breastfeeding policy that is routinely communicated to all health care staff.

10. The 10 Steps: Step 2  Train all health care staff in skills necessary to implement this policy.

11. The 10 Steps: Step 3  Inform all pregnant women about the benefits and management of breastfeeding.

12. The 10 Steps: Step 4  Help mothers initiate breastfeeding within one hour of birth.

13. The 10 Steps: Step 5  Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.

14. The 10 Steps: Step 6  Give newborn infants no food or drink other than breastmilk, unless medically indicated.

15. The 10 Steps: Step 7  Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.

16. The 10 Steps: Step 8  Encourage breastfeeding on demand.

17. The 10 Steps: Step 9  Give no pacifiers or artificial nipples to breastfeeding infants.

18. The 10 Steps: Step 10  Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

19. The 10 Steps  How many steps does your unit do?  Which are consistently done well?  Which can be most improved upon?

20. Do they work?  Surveyed women in the program  Only 7% experienced all 5 steps in the survey  8x more likely to stop BF if 0/5 steps  More steps = more BF  High risk for stopping BF:  Late initiation  Formula supplementation

21. Hospital breastfeeding policy

22. Last Thoughts  Questions?  Take home points…