Brannon, Monica, BSN, RNC-MNN

Cartledge, Jessy, BSN, RNC-MNN

Pfeiffer, Linda, RNC, IBCLC

English

Inova Health System: IDEAS (Inova Digital e-ArchiveS)

Inova Health System
IDEAS: Inova Digital e-ArchiveS
Inova Nursing Research Symposia 2016 Nursing Research Symposium
Nov 14th, 11:25 AM
Excited about Baby Friendly Designation! How do
we Ensure the Momentum for Continued Success?
Monica Brannon BSN, RNC-MNN
Linda Pfeiffer RNC, IBCLC
Jessy Cartledge BSN, RNC-MNN
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Recommended Citation
Brannon, Monica BSN, RNC-MNN; Pfeiffer, Linda RNC, IBCLC; and Cartledge, Jessy BSN, RNC-MNN, "Excited about Baby
Friendly Designation! How do we Ensure the Momentum for Continued Success?" (2016). Inova Nursing Research Symposia. 11.
http://www.inovaideas.org/nursingresearchsymposium/twentysixteen/agenda/11
Introduction and Problem Statement Intervention- Improvement Methods 
PICO Question 
Recommendations 
Intervention Outcomes
Breastfeeding improves health outcomes for mothers and babies. 
Breastfed children have fewer and less severe illnesses,  resulting 
in reduced healthcare costs for families and communities. The 
World Health Organization (WHO) and the United Nations 
Children’s Fund (UNICEF) launched Baby-Friendly Hospital 
Initiative (BFHI) in 1991. In September 2015, Inova Alexandria 
Hospital (IAH) obtained the  prestigious Baby Friendly designation.
As the Family Centered Care  (FCC) Unit experienced staff 
turnover, an acute need arose to educate  staff around the “Ten 
Steps to Successful Breastfeeding,” which is critical to meet Baby-
Friendly criteria, as well as The Joint Commission (TJC) perinatal 
core measure of exclusive breast-milk feeding. A decline also 
occurred in prenatal education at the Community Partner clinic. 
The TJC definition of exclusive breastfeeding excludes  medical 
supplementation.  More than half of TJC accredited hospitals are 
below 50% in this measure.  Baby-Friendly defines exclusive 
breastfeeding as no food or drink other than breast-milk, unless 
medically indicated.  The purpose of this project was to improve 
both TJC and Baby-Friendly exclusive breastfeeding rates.  TJC 
exclusive breastfeeding rate for FCC was 58% in March 2016.  
The Inova system TJC goal is 70%. Our Baby-Friendly exclusive 
breastfeeding rate was 79% in March 2016. The IAH goal is 80%. 
With project initiation the TJC breastfeeding rate remained stable at 
64% Per Baby-Friendly, the exclusive breastfeeding 5 month 
average decreased by 5%. With hardwiring of nursing education, 
physician support, and community partner collaboration, the 
exclusive breastfeeding goal is attainable. 
1. Educate new staff to incorporate Baby-Friendly practices into 
daily bedside care. 
2. Strengthen ties with community partners with the goal of 100% 
prenatal patient education. 
3. Expand to include other community facilities that provide 
prenatal care. 
4. Continue strong leadership support and regular review of 
exclusive breastfeeding rate. 
5. Utilize Baby-Friendly designation as a recruitment tool.
Excited About Baby-Friendly® Designation! How Do We Ensure Momentum for Continued Success?
Monica Brannon, BSN, RNC-MNN; Linda Pfeiffer, RN, IBCLC; Jessy Cartledge, BSN, RNC-MNN; Kanya Fogleman, MSN, RNC-MNN; Jodie Turner, MSN, RN-MHA, NE-BC; Rodica Sandor-Scoma MD, RN, MHSA; Patricia Conde, 
BSN, IBCLC; Robin Harrell, AND, RN4, IBCLC, HTI; Ana Adriazola, BSN, RN-OCN*
References 
1. Bartick, M., Stuebe, A., Shealy, K., Walker, M., Grummer-Strawn, L.M. (2016). 
Closing the Quality Gap: Promoting Evidence-Based Breastfeeding Care in the 
Hospital. Pediatrics (124), e793-802.
2. Bik, D., Murrells, T., Weavers, A., Val, R., Wray, J., Beake, S. (2012). Revising acute 
care systems and processes to improve breastfeeding and maternal postnatal 
health: a pre and post intervention study in one English maternity unit. BMC 
Pregnancy and Childbirth, 12:41
3. Changes to Breast Milk Feeding. (2015, June). Retrieved March 30, 2016, from 
https://www.jointcommission.org/assets/1/18/Breastfeeding_Perf_Measures.pdf
4. Li, C., Li. R., Ashley, C.G., Smiley, J.M., Cohen, J.H., & Dee, D.L. (2014). 
Associations of Hospital Staff Training and Policies with Early Breastfeeding 
Practices. Journal of Human Lactation, 30(1), 88-96.
5. Sinha, B., Chowdhury, R., Sankar, M.J., Martines, J., Taneja, S., Mazumder, S., 
Rollins, N., Bahl, R., Bhandari, N. (2015). Interventions to improve breastfeeding 
outcomes: a systematic review and meta-analysis. Acta Paediatrica (104), 114-135.
Project Goals
1. Develop staff education around the “Ten Steps of Successful 
Breastfeeding.”
2. Collaborate with IAH Community Partner clinic providing 
prenatal education classes on breastfeeding.
3. Improve the exclusive breastfeeding rate.
This project was part of the 2015 Inova Evidence-Based Practice Fellowship Program.
Will staff education in combination with early prenatal education 
increase the exclusive breastfeeding rate?
Literature was reviewed rated and ranked 
utilizing the Johns Hopkins Nursing 
Evidence Based Practice Model. 
Suggestions from patient advisors were 
incorporated.
Staff Education
• Education of RNs and Clinical 
Technicians through scheduled 
breastfeeding skill fairs with hands-on 
simulations regarding positioning and 
latching 
• Review of the “Ten Steps to Successful 
Breastfeeding” and their incorporation 
into daily practice 
• All new hires complete 20 hours of 
online breastfeeding education and 
increasing to 12 hours of hands on 
lactation learning, to embed the “Ten 
Steps to Successful Breastfeeding” into 
daily practice
Monitoring
• Utilizing the Baby Friendly 
definition of exclusive breast-milk 
feeding, daily review of electric 
health records are performed
• During team huddle, the Unit 
Supervisor reviews key 
performance indicators which 
includes review of daily exclusive 
breastfeeding rates 
Community Partnership 
• Collaborate with our community 
partner to conduct prenatal 
education regarding the benefits 
of breastfeeding and 
expectations when delivering in 
a Baby-Friendly Hospital  
Acknowledgements
We would like to thank the following groups:
IAH Staff of Family Centered Care, Labor and Delivery, and Neonatal Intensive Care
*George Mason University, Doctorate of Nursing Practice Student
*Photos used with permission
Inova Alexandria Hospital


Excited about Baby Friendly Designation! How do we Ensure the Momentum for Continued Success?

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Excited about Baby Friendly Designation! How do we Ensure the Momentum for Continued Success?

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