and why it matters in the infant mortality conversation Tina Cardarelli BS IBCLC State Breastfeeding Coordinator tcardarelliindianaperinatalorg A Brief History Of Breastfeeding ID: 229263
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Strategies to Improve Breastfeeding Outcomes in Your Hospital and Community(and why it matters in the infant mortality conversation)Slide2
Tina Cardarelli BS IBCLCState Breastfeeding Coordinator
tcardarelli@indianaperinatal.org Slide3
A Brief
History OfBreastfeedingSlide4Slide5
99.7% Thousands of YearsSlide6
Bottom Line Benefits:From the Beginning of TimeSlide7
So….How can we improve breastfeeding and mortality?Slide8Slide9Slide10
Innocenti Declaration, 8/1990“
Protection, Promotion and Support of Breastfeeding”“Recognize breastfeeding is a unique process that:Provides ideal nutrition for infants and contributes to their healthy growth and development, reduces incidence and severity of infectious diseases, thereby lowering infant morbidity and mortality. “Contributes to women's health by reducing the risk of breast and ovarian cancer, and by increasing the spacing between pregnancies Provides social and economic benefits to the family and the nation” Slide11
“a global goal for optimal maternal and child health and nutrition”
Slide12
Breastfeeding is one of the most effective ways to ensure child health and survival.If every child was breastfed within an hour of birth, given only breast milk for their first six months of life, and continued breastfeeding up to the age of two years,
about 800,000 child lives would be saved every year. WHOSlide13
Inappropriate feeding practices,sub-optimal or no breastfeeding and inadequate complementary feeding remain the greatest threat to child health and survival globally
“Celebrating Innocenti 1990-2005: Achievements,Challenges and Future Imperatives”, 22 November 2005, ItalySlide14
The Clinical DataSlide15
2007 The Agency for Healthcare Research and Quality (AHRQ) reviewed the evidence on the effects of breastfeeding on short-and long-term infant and maternal health
Conclusion: Breastfeeding is associated with a reduced risk of many diseases in both infants and mothersAHRQ Evidence Report Number 153Slide16Slide17
When Babies Don’t Breastfeed…
1756% higher risk of SIDS35% higher risk of Asthma (no family history)67% higher risk of Asthma (with family history)100% higher risk for Ear Infections178% higher risk for Diarrhea & Vomiting (Gastrointestinal Infections)64% higher risk for Type 2 Diabetes23% higher risk for Acute Lymphocytic Leukemia138% higher risk for Necrotizing Enterocolitis (NEC) in preemiesRisk of lower I.Q. – Average of 8 points lower Agency for Healthcare Research and Quality (AHRQ,2007)Slide18
When Women Don’t Breastfeed...18
They recover more slowly after birthHave Increased risk of:Breast Cancer Ovarian Cancer Endometrial Cancer Cardiovascular Disease Osteoporosis Type 2 Diabetes High Blood Pressure Metabolic Syndrome Anemia Postpartum DepressionThe longer a woman breastfeeds, the more her risk of breast cancer goes downSlide19
“Given the short and long term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public
health issue and not only a lifestyle choice”AAP, 2012“One of the most highly effective preventive measuresa mother can take to protect the health of her infant and herself is to breastfeed”Surgeon General, 2011 Professional EndorsementsSlide20
PolicyBaby FriendlymPINCImproved Hospital Practices
Baby Friendly Designation Model Hospital Policy mPINC Survey LINC Slide21
“If we truly understand that breastmilk is the best first food for babies—and our polling shows Americans do—then our institutions and communities need to make it easier for all mothers to nurse……we believe whether a woman breastfeeds shouldn’t be dictated by the quality of health care she receives
.”Dr. Gail Christopher VP W.K. Kellogg Foundation Slide22Slide23
52 questions36 question categories
7 Dimensions of CarePoints value for every questionHigher points given to supportive breastfeeding practicesSub scores categoriesTotal scoreRank
mPINC: Quality Improvement Tool
mPINCSlide24
Indiana’s Maternity Practices in Infant Nutrition and Care (mPINC) Scores, 2007 – 2013
Since 2007, Indiana’s
mPINC
score has continued to rise!
Great Job Indiana!
Source: Centers for Disease Control and Prevention, mPinc State Reports by yearSlide25Slide26
Where In The World Did
“Baby Friendly” Come From ?1990 Innocenti Declaration Global effort to implement practices that protect, promote and support breastfeeding to reduce infant mortality worldwide1991 Baby Friendly launched by WHO and UNICEF Slide27
…And Around
The WorldSlide28Slide29Slide30
Ten Steps to Successful Breastfeeding
Have a written breastfeeding policy that is routinely communicated to all health-care staff.Train all health-care staff in the skills necessary to implement this policy. Inform all pregnant women about the benefits and management of breastfeeding. Help mothers initiate breastfeeding within an hour after birth. Show mothers how to breastfeed and how to maintain lactation even if they are separated from their infants. Slide31
Ten Steps to Successful Breastfeeding
Give newborn infants no food or drink other than breast milk unless medically indicatedPractice rooming-in: allow mothers and infants to stay together, 24 hours a day.Encourage breastfeeding on demand. Give no artificial nipples or pacifiers to breastfeeding infants. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital. Slide32
Funded by The Department of Nutrition and Physical Activity
@The Indiana State Department of Health Slide33
Are You Doing All that You Can to Build a Supportive Breastfeeding Environment in Your Community?Slide34
1.5
hour online continuing education tutorial is designed to meet needs of pediatric primary care providers team http://www.northeastern.edu/breastfeedingcme/Slide35
Physician TrainingSlide36
36Pharmacist Education
www.neurxce.org/user/login Slide37Slide38
State CoalitionClinical and Community CallSlide39Slide40
Community Drop-In Centers Slide41
IU Methodist Tele-Lactation Slide42
Racial InequitySlide43
43Slide44
Child Care TrainingSlide45
One of the easiest things you can do…
Instead of asking: “Are you going to breast or bottle feed?”Ask:“How can we help you to breastfeed?”Slide46
“It is everyone’s role to make breastfeeding easier”
Surgeon General’s Call to Action to Support Breastfeeding,2011Slide47
Feldman-Winter, L., Procaccini, D., & Merewood, A. (2012). A Model Infant Feeding Policy for Baby-Friendly Designation in the USA. Journal of Human Lactation, 28(3), 304-311. doi: 10.1177/0890334412440626
· Hawkins, S. S., Stern, A. D., Baum, C. F., & Gillman, M. W. (2013). Compliance with the Baby-Friendly Hospital Initiative and impact on breastfeeding rates. Arch Dis Child Fetal Neonatal Ed. doi: 10.1136/archdischild-2013-304842· Perrine, C. G., Scanlon, K. S., Li, R., Odom, E., & Grummer-Strawn, L. M. (2012). Baby-Friendly Hospital Practices and Meeting Exclusive Breastfeeding Intention. Pediatrics, 130(1), 54-60. doi: 10.1542/peds.2011-3633· Saadeh, R. J. (2012). The Baby-Friendly Hospital Initiative 20 years on: facts, progress, and the way forward. J Hum Lact, 28(3), 272-275. doi: 10.1177/0890334412446690 Sadacharan, R., Santana, S., Sanchez, E., Matlak, S., Grossman, X., Makrigiorgos, G., & Merewood, A. (2012). Are you Baby-Friendly? Knowledge deficit among US maternity staff. J Hum Lact, 28(3), 359-362. doi: 10.1177/0890334412437039· Venancio, S. I., Saldiva, S. R., Escuder, M. M., &
Giugliani
, E. R. (2012). The Baby-Friendly Hospital Initiative shows positive effects on breastfeeding indicators in Brazil. J
Epidemiol
Community Health, 66(10), 914-918. doi: 10.1136/jech-2011-200332ReferencesSlide48
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· Merewood, A., Patel, B., Newton, K. N., MacAuley, L. P., Chamberlain, L. B., Francisco, P., & Mehta, S. D. (2007). Breastfeeding duration rates and factors affecting continued breastfeeding among infants born at an inner-city US Baby-Friendly hospital. J Hum Lact, 23(2), 157-164. doi: 23/2/157 [pii]· 10.1177/0890334407300573 [doi]· Newton, K. N., Chaudhuri, J., Grossman, X., & Merewood, A. (2009). Factors associated with exclusive breastfeeding among Latina women giving birth at an inner-city baby-friendly hospital. J Hum Lact, 25(1), 28-33. doi: 25/1/28 [pii]· 10.1177/0890334408329437 [doi]· Parker, M., Burnham, L., Cook, J., Sanchez, E., Philipp, B. L., & Merewood, A. (2013). 10 Years after Baby-Friendly Designation: Breastfeeding Rates Continue to Increase in a US Neonatal Intensive Care Unit. Journal of Human Lactation. doi: 10.1177/0890334413489374