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Birth and Beyond California: Hospital Training & Quality Improvement Project

MO-07-0148 BFP

Program Description

The Birth and Beyond California (BBC) Project is an approach to collaborate with hospitals to improve their exclusive breastfeeding rates by establishing hospital policies and a continuous quality improvement plan.  Through partners in the Regional Perinatal Programs of California (RPPC), this project provides technical assistance, resource development, on-site education and training.

Currently the project is being piloted in areas with the lowest exclusive breastfeeding rates beginning with RPPC regions 5 and 6.  Region 5 includes the counties of the Central Valley, Kern, Tulare, Kings, Fresno, Madera, Merced, Mariposa, Stanislaus and Tuolumne.  Region 6 includes Los Angeles, Santa Barbara and Ventura Counties.  Region 8 which includes Orange County will be added in July 2008.  Eight hospitals began the project in early 2008, with a goal of adding 12 new hospitals every 6 months through 2011. 

Birth and Beyond California provides:

  • Training
    • 2 hour Administrator
    • 16 hour Staff
    • 8 hour Train-the-Trainer
  • Technical Assistance for Hospital Quality Improvement Team
    • Policy Revision
    • Evaluation Toolkit
  • Regional Quality Improvement Network meetings
    • Monthly

Background

Organizations that study ways to maintain optimal infant health, such as the American Academy of Pediatrics, American College of Obstetricians and Gynecologists, American Academy of Family Physicians, Academy of Breastfeeding Medicine, World Health Organization, and United Nations Children’s Fund—all recommend exclusive breastfeeding for the first six months of life.  The education and support offered by staff in California hospitals can affect exclusive breastfeeding, not only for the first few days of life, but continued exclusive breastfeeding.

Data published by the California Department of Public Health (CDPH) have demonstrated that even though over 85% of the women in California have decided to breastfeed, fewer than half of these are able to exclusively breastfeed in the short time they are in the hospital.  In some areas of the state, the gap between “any” and “exclusive” breastfeeding is much larger.  This gap has also been shown to be much greater among the populations who have the highest risk for morbidity among their infants. In 2006, only 43 percent of California newborns were exclusively breastfed in the early post-partum period. Disparities in exclusive breastfeeding rates were found to be lowest for Hispanics (32%), African Americans (34%), and Pacific Islanders (41%). All were well below the rate for whites (64%) and the recommended Healthy People 2010 goal of 75%.

In 2006, the CDPH shared with all the hospitals the Model Hospital Policy Recommendations on how to improve hospital exclusive breastfeeding rates.  This was followed by the development of a Toolkit to assist in their implementation in 2007.  In 2008, BBC will provide additional information and resources to assist hospitals in implementing these policies.

Resources

Perinatal Advisory Council: Leadership, Advocacy and Consultation (PAC/LAC) is the contractor for coordinating Birth and Beyond California.  Information on the project is available at their website: www.paclac.org/quality_care/qualityBirthandBeyondCA.htm.

The California Breastfeeding Model Hospital Policy Recommendations Toolkit provides information and resources to implement the breastfeeding policies.