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The Birth and Beyond California (BBC) Project utilizes Quality Improvement (QI) methods and training to implement evidence-based policies and practices that support breastfeeding within the maternity care setting.  The BBC Curriculum was developed as a result of collaboration among the California Department of Public Health (CDPH), Maternal, Child and Adolescent Health (MCAH) Division and many local organizations and individuals (Word)Opens a new browser window..

Utilizing the Regional Perinatal Programs of California (RPPC), this project provided participating hospitals with ongoing quality improvement (QI) technical assistance, resource development and on-site education and training.  The training curriculum was adapted from the successful SOFT Hospital, a project developed by the Perinatal Services Network at Loma Linda University under the leadership of Carol Melcher.

  • Background of BBC
  • BBC Project Report (PDF, 5 MB)Opens a new browser window.
  • Lessons Learned from the Birth and Beyond California Project

    • Hospital administration must form a multidisciplinary quality improvement team charged with implementing evidence-based policies and practices that support breastfeeding within the maternity setting prior to initiating staff training.
    • Hospital Networks provide critical opportunities to share strategies and methods to overcome barriers to evidence-based maternity care and initiation of exclusive breastfeeding.
    • Skin-to-skin and maternal-infant attachment are essential components to hospital staff breastfeeding training.
    • Hospitals need to develop internal trainers to sustain staff competency and provide ongoing breastfeeding education to new and current staff.


    Birth and Beyond Webinar Recording from 11-10-2011 (Select "Run" if asked)

    Comparison of California Model Hospital Policy Recommendations and the Baby Friendly Hospital Initiative-U.S.A.(PDF)The Model Hospital Policies (thus the BBC curriculum) do not meet the requirements for "Baby-Friendly Hospital" designation. Breastfeed LA’s Birth and Beyond Los Angeles (BBLA) and Vermont's Birth and Beyond: Empowering Mothers and Nurturing Babies builds on the BBC training with a focus on "The Ten Steps to Successful Breastfeeding," and adds new content to fulfill training objectives for the "Baby-Friendly Hospital Initiative." 

    Birth and Beyond Los Angeles (BBLA)

    Adopted from Birth and Beyond California, this curriculum was designed by Breastfeed LA.

    Birth & Beyond Vermont: 10 Steps to Empower Mothers and Nurture Babies
    Adopted from Birth and Beyond California, this interactive, comprehensive platform was designed for Vermont's Breastfeeding Quality Improvement Project. To request access to the training materials contact Karen Flynn, WIC Program Administrator at karen.flynn@state.vt.us.


    Below are the project components in the suggested order of implementation.

    Copyright Information:
    © 2011 California Department of Public Health. The components included in the Birth and Beyond California Project may be reproduced and disseminated in any media in its original format, without modification, for informational, educational and non-commercial purposes only. A nominal sum to cover costs of reproduction and distribution can be assessed. Any modification or use of the materials in any derivative work is prohibited without prior written permission of the California Department of Public Health, Maternal, Child and Adolescent Health Division.

    Alert If a hospital or geographic region is not yet ready to start implementing this project, go to the Perinatal Multidisciplinary Quality Improvement Tutorial for additional resources.

    Note to trainers: All of the documents and evaluation tools below are necessary to present either the Staff Training or the Train-the-Trainer Workshop.

    AlertPictures are NOT included in these PowerPoints. * The listing of photos used in the staff training can be found in the BBC Photo Bibliography (Word)Opens a new browser window.

    1. Decision-Maker Workshop - 2 Hours **

        Curricular Materials for Trainers:

  • Purpose/Description
  • Content
  • PowerPoints
  • Handouts
  • Supplementary Material
  • Evaluation
  • 4. Staff Training / Learner Workshop - 16 Hour **

         Curricular Materials for Trainers:

  • Purpose/Description
  • Staff Training/Learner Workshop Materials
  • Evaluation of the Staff Training
  • 2. Hospital Quality Improvement Teams **

         Resources for Initiating and Managing Teams:

  • Purpose/Description
  • Tools
    • QI Team Worksheet
    • Model Hospital Policy Self-appraisal
    • Action Plan
    5. Train-the-Trainer Workshop - 16 Hours **

         Curricular Materials for Trainers:

  • Purpose/Description
  • Train the Trainer Manual
  • Detailed Session Plans: Key Messages and Rationale, Recommended Tools, Supply List, and  Videos for each of the13 Staff Training Modules
  • Evaluation of the Train the Trainer Workshop
  • 3. Regional Quality Improvement Network **

         Resources for Initiating and Managing Networks:

  • Purpose/Description
  • Sample Tools
    • Invitations
    • Agendas
    • Plan, Do, Check Act (PDCA) Cycle
    • PDCA Flow Chart
    • Improving Hospital Rates with BBC and PDCA
    6. Evaluation Toolkit **

        Resources for Monitoring and Evaluating the Project:

  • Purpose/Description
  • Plan, Do, Check, Act (PDCA) Model
  • Evaluation Materials used in:
    • Decision-Maker Workshop
    • Staff Training (16 hour Learner Workshop)
    • Train-the-Trainer Workshop
    • Regional Quality Improvement Network
    • BBC Hospital Breastfeeding Data Collection examples

    * A majority of the photos used in these curricula were from the Breastfeeding Atlas (Third Edition), are protected by copyright and cannot be reproduced for sale or free mass distribution. Photos may be imported into training presentations and may be used for in-services and presentation when rights are purchased. The Breastfeeding Atlas institutional license is available at http://www.breastfeedingmaterials.com. Use of your own photos or photos of patients, with the appropriate permissions, is encouraged.

    ** A BBC document developed by RPPC with Title V funding through CDPH/MCAH, 2010.



    Last modified on: 4/17/2017 9:23 AM