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Human Milk Feeding Initiative Change Package

General Resources
  • Coffective Staff Education. Staff education provided free to hospitals by the Department of Health Services – Chronic Disease Unit to all hospitals. Contact Kelli Stader: [email protected]
  • AAP and ACOG. Guidelines for Perinatal Care, 7th Edition. 2012. Chicago, IL and Washington, DC: AAP and ACOG. Chapters 6-8.
  • Baby Friendly.  http://www.babyfriendlyusa.org/
  • The Academy of Breastfeeding Medicine – Clinical Protocols. Accessed Jan 20, 2017. Download here.
  • ACOG Breastfeeding Toolkit. Accessed Jan 20, 2017. Download here.
  • AWHONN. Breastfeeding. JOGNN. 2015;44:145-150. Download here.
  • The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.  Provides state and local community members information to choose the breastfeeding intervention strategy that best meets their needs. Accessed Jan 20, 2017. Download here.
  • Maternity Practices in Infant Nutrition and Care (mPINC) Survey. CDC’s national survey of Maternity Practices in Infant Nutrition and Care (mPINC) is administered every two years to monitor and examine changes in practices over time at all hospitals and birth centers with registered maternity beds in the United States and Territories. Accessed Jan 20, 2017. Download here.
  • Promising Practices in First Nations and Aboriginal Maternal and Child Health Programs: Community Perspectives on What Works. Sep 2015. Download here.
Measure 1: Prenatal Education (2018)

Required for community-based obstetric care providers

Measure: 100% documented prenatal education on human milk feeding using Criterion 3.4.1 from the Baby Friendly guidelines.

Criterion 3.4.1: A written description of in-house and/or community-based programs and projects the facility has fostered will be available and will cover, at minimum, the importance of breastfeeding, the importance of exclusive breastfeeding for about 6 months, and basic breastfeeding management (e.g., skin-to-skin contact, rooming-in, and risks of supplements while breastfeeding in the first 6 months).
Ref: https://www.babyfriendlyusa.org/get-started/the-guidelines-evaluation-criteria

Numerator: All patients receiving prenatal care who delivered in the data collection month with documented prenatal education on human milk feeding using Criterion 3.4.1 from the Baby Friendly guidelines
Denominator: All patients receiving prenatal care who delivered in the data collection month

Data sources: Local electronic health record; manual abstraction

 

  • Coffective Education App.  Free App will provide prenatal education to parents about rooming in; skin-to-skin and supplementation. Both Android and Apple available. Contact Kelli Stader: [email protected]
  • Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #19 Breastfeeding Promotion in the Prenatal Setting, Revision 2015.  Breastfeed Med. 2015;10(10):451-457. Download here.
  • Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #7: Model Breastfeeding Policy Revision 2010.  Breastfeed Med. 2010;5(4):173-177. Download here.
  • ACOG Committee on Health Care for Underserved Women.  Committee Opinion #570: Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding.  Aug 2013; reaffirmed 2016. Download here.
  • ACOG Committee on Obstetric Practice.  Committee Opinion #658: Optimizing Support for Breastfeeding as Part of Obstetric Practice.  Feb 2016. Download here.
  • ACOG.  Breastfeeding Infographic.  Accessed Jan 20, 2017. Download here.  English version is available for ACOG members.
  • ACOG.  Physician Conversation Guide on Support for Breastfeeding.  Accessed Jan 20, 2017. Download here.
  • AWHONN.  Breastfeeding Support: Prenatal Care Through the First Year, Second Edition.  2007. Evidence-based clinical practice guideline. Download here.
  • AWHONN. Prepare for Breastfeeding. Accessed Oct 17, 2017. Download here.
  • Cottrell BH, Detman LA.  Breastfeeding concerns and experiences of African American mothers.  MCN Am J Matern Child Nurs. 2013 Oct;38(5):297–304.
  • Feldman-Winter L, Goldsmith JP, COMMITTEE ON FETUS AND NEWBORN, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME.  Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.  Pediatrics. 2016 Sep;138(3):e1-e10. Download here.
  • Groleau D, Pizarro KW, Molino L, Gray-Donald K, Semenic S.  Empowering women to breastfeed: Does the Baby Friendly Initiative make a difference?  Matern Child Nutr. 2016 Nov 29.
  • How Doctors Can Help: The Surgeon General’s Call to Action to Support Breastfeeding.  Accessed Jan 20, 2017. Download here.
  • It’s only natural: mother’s love, mother’s milk.  It’s Only Natural helps African-American women and their families understand the health benefits of breastfeeding—not just for babies, but for moms too. Accessed Jan 20, 2017. Download here.
  • La lactancia maternal.  Accessed Jan 20, 2017. Download here.
  • NICHD.  Healthy Native Babies Project: Workbook and Toolkit.  Jun 2010. Pages 22-24. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: Department of Health and Human Services, Office of the Surgeon General; 2011. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding.  2011. Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):e1341-1367. Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):1030–1039. Download here.
  • Task Force on Sudden Infant Death Syndrome.  SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.  Pediatrics. 2016 Nov 1;138(5):e20162938. Download here.
  • The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.  Provides state and local community members information to choose the breastfeeding intervention strategy that best meets their needs. Accessed Jan 20, 2017. Download here.
  • Tully KP, Holditch-Davis D, Silva S, Brandon D.  The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-being Among Mothers of Late Preterm and Term Infants: A Secondary, Exploratory Analysis.  Adv Neonatal Care. 2016 Aug 16.
  • Wisconsin Department of Health Services.  Breastfeeding Education.  Accessed Jan 20, 2017. Download here.
  • Wisconsin Department of Health Services.  Breastfeeding Resources.  Accessed Jan 20, 2017. Download here.
  • Wisconsin WIC  – Providing information to moms prenatally about skin-to-skin, rooming-in, and supplementation. Contact Jennifer Ortner: [email protected]
  • Your Guide to Breastfeeding for African American Women.  Jan 2011. Download here.

 

Measure 2: Skin-to-Skin after Delivery (2018)

Measure:  90% of mothers hold healthy term newborns (≥ 37 weeks 0 days gestation) skin-to-skin, uninterrupted, for at least 60 minutes, or until the completion of the first feeding, beginning within one hour of birth for uncomplicated vaginal births and within 2 hours of uncomplicated Cesarean deliveries

Numerator:  All healthy term newborns (≥ 37 weeks 0 days gestation) who are placed skin-to-skin with their mother for at least 60 minutes, or until completion of the first feeding, beginning within one hour of birth for uncomplicated vaginal births and within 2 hours of uncomplicated Cesarean deliveries
Denominator:  All healthy term newborns (≥ 37 weeks 0 days gestation) born via vaginal or Cesarean birth

Exclusions:

  • Newborns of mothers who are not responsive, or are unstable following birth;
  • Newborns of mothers with a severe illness that prevents them from caring for their infants, e.g., sepsis;
  • Newborns with a diagnosis that requires admission to special care or neonatal intensive care unit at birth;
  • Newborns who are being adopted whose birth mothers choose not to initiate immediate contact.

Data sources:  PeriData.Net®; manual abstraction

 

  • Coffective Staff Education:  Skin to Skin Staff education provided free to hospitals by the Department of Health Services – Chronic Disease Unit to all hospitals. Contact Kelli Stader: [email protected]
  • Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #7: Model Breastfeeding Policy (Revision 2010).  Breastfeed Medicine. 2010;5(4):173-177. Download here.
  • AWHONN. Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5. JOGNN. 2016;45(6):842-844. Download here.
  • Crenshaw JT.  Healthy Birth Practice #6 Keep Mother and Baby–Together It’s Best for Mother, Baby and Breastfeeding.  J Perinat Educ. 2014;23(4):211-217. Download here.
  • Dumas L, Lepage M, Bystrova K, Matthiesen A-S, Welles-Nyström B, Widström A-M.  Influence of skin-to-skin contact and rooming-in on early mother-infant interaction: a randomized controlled trial.  Clin Nurs Res. 2013 Aug;22(3):310–336. Download here.
  • Feldman-Winter L, Goldsmith JP, COMMITTEE ON FETUS AND NEWBORN, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME.  Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.  Pediatrics. 2016 Sep;138(3). Download here.
  • How Nurses Can Help: The Surgeon General’s Call to Action to Support Breastfeeding.  Download here.
  • Hung KJ, Berg O.  Early skin-to-skin after Cesarean to improve breastfeeding.  MCN Am J Matern Child Nurs.; 2011 Sep-Oct;36(5): 318-324.
  • Koopman I, Callaghan-Koru JA, Alaofin O, Argani CH, Farzin A.  Early skin-to-skin contact for healthy full-term infants after vaginal and caesarean delivery: a qualitative study on clinician perspectives.  J Clin Nurs. 2016 May;25(9–10):1367-1376.
  • Moore ER, Bergman N, Anderson GC, Medley N.  Early skin-to-skin contact for mothers and their healthy newborn infants.  Cochrane Database Syst Rev. 2016 25;11:CD003519.
  • Redshaw M, Hennegan J, Kruske S.  Holding the baby: early mother-infant contact after childbirth and outcomes.  Midwifery. 2014 May;30(5):e177-e187.
  • Robiquet P, Zamiara P-E, Rakza T, Deruelle P, Mestdagh B, Blondel G, et al.  Observation of Skin-to-Skin Contact and Analysis of Factors Linked to Failure to Breastfeed Within 2 Hours After Birth.  Breastfeed Med. 2016 Mar 15;11(3):126–132.
  • Stone S, Prater L, Spencer R.  Facilitating skin-to-skin contact in the operating room after cesarean birth.  Nurs Womens Health. 2014 Dec;18(6):486–499.
  • World Health Organization.  Thermal Protection of the Newborn: a practical guide.  1997 WHO initiative promoting “The Warm Chain.” Download here.
Measure 3: Skin-to-Skin for Procedures

Measure:  90% of mothers hold healthy term newborns (≥ 37 weeks 0 days gestation) skin-to-skin while necessary routine newborn procedures and assessments are done within the first hour after uncomplicated vaginal deliveries

Numerator:  All healthy term newborns (≥ 37 weeks 0 days gestation) for whom necessary routine newborn procedures and assessments are performed within the first hour while the mother is holding skin-to-skin after uncomplicated vaginal births
Denominator:  All healthy term newborns (≥ 37 weeks 0 days gestation) for whom routine newborn procedures are performed

Exclusions:

  • Newborns of mothers who are not responsive, or are unstable following birth;
  • Newborns of mothers with a severe illness that prevents them from caring for their infants, e.g., sepsis;
  • Newborns with a diagnosis that requires admission to special care or neonatal intensive care unit at birth;
  • Newborns who are being adopted whose birth mothers choose not to initiate immediate contact.

Data sources:  PeriData.Net®; manual abstraction

 

  • Feldman-Winter L, Goldsmith JP, COMMITTEE ON FETUS AND NEWBORN, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME.  Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.  Pediatrics. 2016 Sep;138(3). Download here.
  • How Nurses Can Help: The Surgeon General’s Call to Action to Support Breastfeeding. Download here.
Measure 4: Rooming-in (2018)

Measure:  90% of healthy term newborns (≥ 37 weeks 0 days gestation), regardless of feeding method, remain with their mothers greater than or equal to 23 hours per day

Numerator:  All healthy term newborns (≥ 37 weeks 0 days gestation), regardless of feeding method, who remain with their mothers greater than or equal to 23 hours per day
Denominator:  All healthy term newborns (≥ 37 weeks 0 days gestation) delivered

Exclusions:

  • Newborns of mothers who are not responsive, or are unstable following birth;
  • Newborns of mothers with a severe illness that prevents them from caring for their infants, e.g., sepsis;
  • Newborns with a diagnosis that requires admission to special care or neonatal intensive care unit at birth;
  • Newborns who are being adopted whose birth mothers choose not to initiate immediate contact.

Data sources:  PeriData.Net®; manual abstraction

 

  • Coffective Staff Education.  Staff education provided free to hospitals by the Department of Health Services – Chronic Disease Unit to all hospitals. Contact Kelli Stader: [email protected]
  • Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #7: Model Breastfeeding Policy  (Revision 2010). Breastfeed Med. 2010;5(4):173-177. Download here.
  • Feldman-Winter L, Goldsmith JP, COMMITTEE ON FETUS AND NEWBORN, TASK FORCE ON SUDDEN INFANT DEATH SYNDROME.  Safe Sleep and Skin-to-Skin Care in the Neonatal Period for Healthy Term Newborns.  Pediatrics. 2016 Sep;138(3). Download here.
  • How Nurses Can Help: The Surgeon General’s Call to Action to Support Breastfeeding.  Download here.
  • Jaafar SH, Ho JJ, Lee KS.  Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding.  Cochrane Database Syst Rev. 2016 Aug 26;(8):CD006641.
  • Smith LA, Geller NL, Kellams AL, Colson ER, Rybin DV, Heeren T, et al.  Infant Sleep Location and Breastfeeding Practices in the United States, 2011–2014.  Acad Pediatrics. 2016 Aug 1;16(6):540–549.
Measure 5: Exclusive human milk feeding during hospitalization (2018)

Measure:  Greater than 70% of healthy term (≥ 37 weeks 0 days gestation) infants receive human milk exclusively through the day of discharge

Numerator:  All healthy term newborns (≥ 37 weeks 0 days gestation), who receive human milk exclusively through the day of discharge. (Use of glucose for painful procedures is not considered a supplemental feeding.)
Denominator:  Healthy term newborns (greater than or equal to 37 weeks 0 days gestation)

Exclusions:

  • Admitted to the Neonatal Intensive Care Unit (NICU) at this hospital during the hospitalization
  • ICD-10-CM Other Diagnosis Codes for galactosemia as defined in Appendix A, Table 11.21 (Joint Commission)
  • ICD-10-PCS Principal Procedure Code or ICD-10-PCS Other Procedure Codes for parenteral nutrition as defined in Appendix A, Table 11.22 (Joint Commission)
  • Experienced death
  • Length of stay >120 days
  • Enrolled in clinical trials
  • Patients transferred to another hospital

Data sources:  PeriData.Net®; manual abstraction

 

  • Coffective Staff Education.  Staff education provided free to hospitals by the Department of Health Services – Chronic Disease Unit to all hospitals. Contact Kelli Stader: [email protected]
  • Academy of Breastfeeding Medicine Protocol Committee.  ABM Clinical Protocol #7: Model Breastfeeding Policy (Revision 2010).  Breastfeeding Medicine. 2010;5(4):173-177. Download here.
  • Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol # 3: Supplementation.  Download here.
  • Boban M, Zakarija-Grkovi I.  In-Hospital Formula Supplementation of Healthy Newborns: Practices, Reasons, and Their Medical Justification.  Breastfeed Med. 2016 Nov;11:448–454.
  • How Nurses Can Help: The Surgeon General’s Call to Action to Support Breastfeeding.  Download here.
  • Nelson JM, Perrine CG, Scanlon KS, Li R.  Provision of Non-breast Milk Supplements to Healthy Breastfed Newborns in U.S. Hospitals, 2009 to 2013.  Matern Child Health J. 2016 Nov 1;20(11):2228–2232.
  • Pierro J, Abulaimoun B, Roth P, Blau J.  Factors Associated with Supplemental Formula Feeding of Breastfeeding Infants During Postpartum Hospital Stay.  Breastfeed Med. 2016 May;11:196–202.
  • Thulier D.  Challenging Expected Patterns of Weight Loss in Full-Term Breastfeeding Neonates Born by Cesarean. J Obstet Gynecol Neonatal Nurs. 2017;46(1):18-28.
  • Thulier D.  Weighing the Facts: A Systematic Review of Expected Patterns of Weight Loss in Full-Term, Breastfed Infants.  J Hum Lact. 2016 Feb;32(1):28–34.
Measure 6: Pumping or Manual Expression after Separation

Measure:  Increase by 5-15 percentage points* the number of women separated from their infants for a medical condition (maternal or neonatal) who pump or manually express milk within 6 hours of separation during maternal hospitalization
*Sites will select the target based on an assessment of their baseline.

Numerator:  All women who are separated from their infants for a medical condition (maternal or neonatal) during maternal hospitalization who pump or manually express breast milk within 6 hours of separation
Denominator:  All women who are separated from their infants for a medical condition (maternal or neonatal) during maternal hospitalization

Exclusions:

  • Mothers who are not responsive, or are unstable following birth;
  • Mothers with a severe illness that prevents them from caring for their infants, e.g., sepsis.

Data sources:  PeriData.Net®; manual abstraction

 

  • Breastfeeding and the Infant with Special Needs.  This Webinar was developed by WIC and the Waisman Center in collaboration with Children and Youth with Special Health Care Needs. (Nov 2016). Access here.
  • Nancy Morhbacher Blog – To Pump More Milk, Use Hands-On Pumping. Access here.
Measure 7: Mother's Own Milk Feeding in the NICU (2018)

Required for NICUs

Measure: Increase the use of maternal milk by 10-20%* in infants with birth weights of 1500 grams or less during their 28th day of life in the NICU.
*Sites will select the target based on an assessment of their baseline.

Numerator: All infants with a birth weight of 1500 grams or less who are 28 days old in the collection month who receive any maternal milk on their 28th day of life
Denominator: All infants with a birth weight of 1500 grams or less who are 28 days old in the collection month

Data sources: PeriData.Net®; manual abstraction

 

  • Breastfeeding a baby with a health problem. Download here.
  • Meier PP, Engstrom JL, Rossman B. Breastfeeding Peer Counselors as Direct Lactation Care Providers in the Neonatal Intensive Care Unit. J Hum Lact. 2013 Aug;29(3):313-322. Download here.
  • NANN. A Guide to Prepare NICU Parents for Home. Download here.
  • NANN. Position Statement #3065: The Use of Human Milk and Breastfeeding in the Neonatal Intensive Care Unit. Download here.
  • Spatz DL. Ten Steps for Promoting and Protecting Breastfeeding for Vulnerable Infants. J Perinat Neonat Nurs. 2004;18(4):385-396. Download here.
Measure 7a: Any human milk at discharge from the NICU (2018)

Measure: Increase the use of any human milk by 10-20%* in infants with birth weights of 1500 grams or less at discharge from the NICU

*Sites will select the target based on an assessment of their baseline

Numerator: All infants with a birth weight of 1500 grams or less who receive any human milk at discharge from the NICU
Denominator: All infants with a birth weight of 1500 grams or less discharged from the NICU

Data sources: PeriData.Net®; manual abstraction

Measure 7b: Exclusive human milk feeding at discharge from the NICU (2018)

Measure: Increase the exclusive use of human milk by 10-20%* in infants with birth weights of 1500 grams or less at discharge from the NICU.

*Sites will select the target based on an assessment of their baseline

Numerator: All infants with a birth weight of 1500 grams or less who receive human milk exclusively at discharge from the NICU
Denominator: All infants with a birth weight of 1500 grams or less discharged from the NICU

Data sources: PeriData.Net®; manual abstraction

Measure 8: Human Milk Feeding after Discharge (2018)

Required for community-based infant/pediatric care providers

Measure:  Increase any human milk feeding at 3-4 months

Numerator:  All infants who receive any human milk at 3-4 months
Denominator:  All infants who are seen at 3-4 months

Data sources:  Local electronic health record; manual abstraction

 

  • AAP Section on Breastfeeding.  Breastfeeding and the Use of Human Milk.  Pediatrics. 2012;129(3):e827-e841. Download here.
  • ACOG Committee on Health Care for Underserved Women.  Committee Opinion #570: Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding.  Download here.
  • American Academy of Pediatrics Breastfeeding Initiatives Web site.  Includes links to free archived Webinars. Download here.
  • AWHONN.  Breastfeeding Support: Prenatal Care Through the First Year, Second Edition.  Evidence-based clinical practice guideline. Download here.
  • Breastfeeding Matters – The Pediatrician’s Role.  Unit 1 is designed to provide guidance to help pediatricians deal with common issues that arise in the early months of breastfeeding. Download here.
  • Duijts L, Jaddoe VWV, Hofman A, Moll HA.  Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy.  Pediatrics. 2010;126(1):e18-e25. Download here.
  • How Doctors Can Help: The Surgeon General’s Call to Action to Support Breastfeeding.  Download here.
  • It’s only natural: mother’s love, mother’s milk.  It’s Only Natural helps African-American women and their families understand the health benefits of breastfeeding—not just for babies, but for moms too. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  The Surgeon General’s Call to Action to Support Breastfeeding. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding.   Download here.
  • Raisler J, Alexander C, O’Campo P.  Breast-Feeding and Infant Illness: A Dose-Response Relationship?  Am J Public Health. 1999;89(1):25-30. Download here.
  • Scariati PD, Grummer-Strawn LM, Beck Fein S. A  Longitudinal Analysis of Infant Morbidity and the Extent of Breastfeeding in the United States.  Pediatrics. 1997;99(6):E5. Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):e1341-1367 Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):1030–1039. Download here.
  • Task Force on Sudden Infant Death Syndrome.  SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.  Pediatrics. 2016 Nov 1;138(5):e20162938. Download here.
  • The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.  Provides state and local community members information to choose the breastfeeding intervention strategy that best meets their needs. Download here.
  • Your Guide to Breastfeeding for African American Women.  Download here.
Measure 9: Exclusive Human Milk Feeding after Discharge (2018)

Measure:  Increase exclusive human milk feeding at 3-4 months

Numerator:  All infants who receive human milk exclusively at 3-4 months
Denominator:  All infants who are seen at 3-4 months

Data sources:  Local electronic health record; manual abstraction

 

  • AAP Section on Breastfeeding.  Breastfeeding and the Use of Human Milk.  Pediatrics. 2012;129(3):e827-e841. Download here.
  • ACOG Committee on Health Care for Underserved Women.  Committee Opinion #570: Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding.  Download here.
  • American Academy of Pediatrics Breastfeeding Initiatives Web site.  Includes links to free archived Webinars. Download here.
  • AWHONN.  Breastfeeding Support: Prenatal Care Through the First Year, Second Edition.  Evidence-based clinical practice guideline. Download here.
  • Breastfeeding Matters – The Pediatrician’s  Role. Unit 1 is designed to provide guidance to help pediatricians deal with common issues that arise in the early months of breastfeeding. Download here.
  • Duijts L, Jaddoe VWV, Hofman A, Moll HA.  Prolonged and Exclusive Breastfeeding Reduces the Risk of Infectious Diseases in Infancy.  Pediatrics. 2010;126(1):e18-e25. Download here.
  • How Doctors Can Help: The Surgeon General’s Call to Action to Support Breastfeeding. Download here.
  • It’s only natural: mother’s love, mother’s milk.  It’s Only Natural helps African-American women and their families understand the health benefits of breastfeeding—not just for babies, but for moms too. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  The Surgeon General’s Call to Action to Support Breastfeeding. Download here.
  • Office of the Surgeon General (US), Centers for Disease Control and Prevention (US), Office on Women’s Health (US).  Executive Summary: The Surgeon General’s Call to Action to Support Breastfeeding.  Download here.
  • Raisler J, Alexander C, O’Campo P.  Breast-Feeding and Infant Illness: A Dose-Response Relationship?  Am J Public Health. 1999;89(1):25-30. Download here.
  • Scariati PD, Grummer-Strawn LM, Beck Fein S.  A Longitudinal Analysis of Infant Morbidity and the Extent of Breastfeeding in the United States.  Pediatrics. 1997;99(6):E5. Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):e1341-1367. Download here.
  • Task Force on Sudden Infant Death Syndrome, Moon RY.  SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environment.  Pediatrics. 2011 Nov;128(5):1030–1039. Download here.
  • Task Force on Sudden Infant Death Syndrome.  SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.  Pediatrics. 2016 Nov 1;138(5):e20162938. Download here.
  • The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.  Provides state and local community members information to choose the breastfeeding intervention strategy that best meets their needs. Download here.
  • Tully KP, Holditch-Davis D, Silva S, Brandon D.  The Relationship Between Infant Feeding Outcomes and Maternal Emotional Well-being Among Mothers of Late Preterm and Term Infants: A Secondary, Exploratory Analysis.  Adv Neonatal Care. 2016 Aug 16.
  • Wambach K, Domian EW, Page-Goertz S, Wurtz H, Hoffman K.  Exclusive Breastfeeding Experiences among Mexican American Women.  J Hum Lact. 2016 Feb;32(1):103–111. Download here.
  • Your Guide to Breastfeeding for African American Women.  Download here.
Measure 10: Human Milk Feeding at Discharge (2018)

Measure: Decrease the number of infants not receiving human milk by 50% from baseline

Numerator: All healthy term newborns (≥ 37 weeks 0 days gestation) who are receiving any human milk at discharge
Denominator: All healthy term newborns (≥ 37 weeks 0 days gestation)

Data sources: PeriData.Net®; local electronic health record; manual abstraction

Safe Sleep

Sudden Unexpected Postnatal Collapse

  • Davanzo R, De Cunto A, Paviotti G, Travan L, et al. Making the first days of life safer: Preventing Sudden Unexpected Postnatal Collapse while promoting breastfeeding. J Human Lact. 2015;31(1):47-52.
  • Ludington-Hoe SM, Morgan K. Infant assessment and reduction of Sudden Unexpected Postnatal Collapse risk during skin-to-skin contact. Newborn Inf Nurs Rev. 2014;14(1):28-33.