Tuesday, October 5, 2010

Cindy Hunter radio interview re Haiti trip

Cindy Hunter was interviewed this morning on The Wake Up Call with Holloway and Lundun. Robb Holloway conducted the interview and shared that a baby will soon be born to his family. 

Formerly with the PeaceHealth Nurse-Midwifery Birth Center, Cindy is now the Nurse Educator for Labor and Delivery at Sacred Heart. She is also a recent recipient of the Lane County 2010 Healthy Babies Award.

The interview was scheduled in anticipation of Friends of the Birth Center’s fireside chat with Cindy this evening. The chat is scheduled in honor of National Midwifery Week

Thanks Robb Holloway for a local discussion about practices to improve maternal and infant well being in this country, in Haiti and elsewhere. The discussion touched on the idea that in this country/community we are working hard to bring back the low-tech, mother- and baby-focused practices including skin-to-skin contact and breastfeeding that can improve our troubling local/national outcomes. In other countries, including Haiti, accessing the technical knowledge and expertise that are plentiful in much of the US is a top priority for improving outcomes.

Here are the highlights….

  • Skin-to-skin contact. Robb asked about the importance of this for mother and babies. It’s a common practice around the world but not so much in this country. As birth moved inside the hospital, mothers and babies were routinely separated. Now, we’re trying to keep them together with skin-to-skin contact for the first hour.
  • Are we behind the world in our childbirth practices? Cindy responded that in many places around the world, Haiti for example, having a skilled birth attendant is not common but rather a luxury. However, US neonatal and maternal mortality rates are not what they should be. (Indeed, Lane County fetal and infant mortality rates are higher than much of the United States and many other nations. Recent coverage.)
  • Haiti. Its maternal and neonatal mortality is the world’s highest. Cindy described that many of the circumstances contributing to poor outcomes (anemia, food insecurity and poverty) are normal for the affected families. She described how heart wrenching it is to witness this. It is not uncommon to find babies in the care of grandmothers and aunts due to a woman dying in childbirth.
  • Parenting. Robb asked about parenting under such extreme circumstances. Cindy described the Haitians with whom she came into contact as extremely resilient. Families are tightly knit and they work together. 
  • Breastfeeding. One of the most striking and important lessons Cindy took from her experience in Haiti was the power of breastfeeding to protect babies from infection and disease. Breastfeeding babes were “fat and happy.” It was when they weaned that they became vulnerable. 

Friday, October 1, 2010

Congrats to Friends' Katharine Gallagher, Midwife Cindy Hunter, UO Project FEAT for Healthy Babies Awards!



Congratulations to the Lane County Healthy Babies 2010 Award Recipients recognized at yesterday’s second-annual reception!

Awards were given to an individual, a practitioner and an organization in acknowledgement of their contributions toward reducing fetal-infant mortality and increasing community health in Lane County. Former KEZI news anchor Rick Dancer served as the master of ceremonies. Dancer encouraged Healthy Babies to use social media to increase its reach. Commissioner Rob Handy and Lane Co. Health and Human Services' Director Rob Rockstroh both emphasized the critical importance of reducing Lane County’s uniquely high rates of fetal and infant mortality.

Individual. Katharine Gallagher, chair of the Lane County Friends of the Birth Center, was recognized in the individual category. Katharine touched on the importance of evidence-based mother- and baby-centered care in improving community outcomes and on the need for ongoing county support for the Healthy Babies initiative. (See Katharine’s comments below)
Katharine Gallagher & Cindy Hunter

Practitoner. Cindy Hunter, former Nurse-Midwifery Birth Center midwife and currently the Nurse Educator for Labor and Delivery at Sacred Heart, was recognized in the practitioner category. Cindy shared her inspiring story about discovering the importance of and ultimately in finding ways to ensure dignified care for women and babies. LaneCoFBC looks forward to its upcoming October 5 fireside chat with Cindy. She will be sharing her recent experiences volunteering in Haiti. (Learn more here.)

Organization. Project FEAT (Family Advocacy and Treatment) coordinators Kristin Funk and Liz Twombly reflected on the lessons learned and insights gained throughout their 5-year project funded by the Department of Health and Human Services to develop policies and procedures for addressing the special needs of substance exposed newborns. Kristin and Liz highlighted the importance of nurturing and protecting mother-child bonds and the power that this connection can have to inspire women to move beyond substance abuse. 
If you missed the the recent media focus on Lane County Healthy Babies, here are links to the coverage:

To get involved or for more information about the Healthy Babies initiative, visit www.preventionlane.org. The next Healthy Babies meeting is on October 7 from 8:30 to 10am at Lane County Mental Health.

Following are LaneCoFBC Chair Katharine Gallagher’s comments:
Thank you very much for this award - I am honored by the acknowledgement.

Little did I know that founding Friends of the Birth Center to encourage construction of the new PeaceHealth Nurse Midwifery Birth Center would be the beginning of a genuinely rewarding endeavor. Like all worthwhile efforts, it’s been a joint one from the start.

Practically over night Friends of the Birth Center brought many, many other women, families and community members together. Families with brand new babies and families with kids graduating high school shared their stories. This evening, three founding members who now serve on the Friends’ board join me: Eleanor Vandergrift, Karen Guillemin and Kathy Lynn. Our other board member, Renee Bailey, could not attend.

Karen Guillemin, Katharine Gallagher, Kathy Lynn, Eleanor Vandegrift
And a founding Dad – my husband David Wacks as well as a Birth Center grandfather – my dad Mike Gallagher.

Originally seeking to maintain our personal preference for maternity services in a freestanding birth center, we quickly made connections between the holistic, communal and mother-baby focused approach we know so well and the local and national discussions about the power of preventive, evidence-based and cost effective care to dramatically improve maternal- and infant-wellbeing.

A strong link exists between the care we regularly access at the Birth Center and what is needed to increase community-level wellbeing. Early prenatal care regardless of insurance status, regular postpartum opportunities to meet other new parents, and ongoing breastfeeding support that really works – this is the “standard issue” package for anyone walking through the Birth Center’s doors.

As we were making these connections, the Friends group began to learn about our community’s local rates for fetal and infant mortality. We have been moved to view construction of the new Birth Center as one of great importance for the entire community. This is because it is a living laboratory of the kind of care we need to see more of in Lane County. Accordingly, we remain very grateful to PeaceHealth for making the new Birth Center a reality.

Moving forward, I look forward and I know Friends of the Birth Center does, too, to supporting the County’s initial efforts to focus our collective attention and resources on reducing fetal and infant mortality. The most recent statistics show some improvement and I believe that is a credit to the Healthy Babies, Healthy Communities initiative. If we are to continue making progress, ongoing county and community support are necessary.


Monday, September 20, 2010

Fireside Chat with Cindy Hunter on Haiti

In celebration of National Midwifery Week 2010, the Lane County Friends of the Birth Center invites you to join us on Tuesday, October 5th at 7 pm at the PeaceHealth Nurse Midwifery Birth Center for a Fireside Chat with Cindy Hunter, a former midwife with the Birth Center who is now based at Sacred Heart Medical Center. Cindy will share her experience working at a clinic in Haiti for a week in May 2010 as part of team organized by Midwives for Haiti. Midwives for Haiti is an organization dedicated to educating midwives in Haiti and providing health care teams to help keep women and their babies as safe as possible in Haiti’s difficult situation. (See our earlier post discussing Cindy's trip to Haiti here.)

The January 12th earthquake in Haiti killed more than 200,000 Haitians and left over 1.5 million people living in temporary camps. As reported by NOW on PBS in a documentary on saving Haiti’s mothers, challenges in transportation, education, and quality health care contribute to Haiti having the highest maternal mortality rate in the Western Hemisphere, a national crisis even before the earthquake struck. Worldwide, over 500,000 women die each year during pregnancy. The United Nations Population Fund, which trains midwives to share life-saving birth techniques and serve in rural communities, says that with proper funding, public support, and wider application of simple but scarce innovations, such deaths could be reduced by nearly 70 percent.

“The reproductive health needs of the population are often forgotten in the aftermath of a disaster,” said UNFPA Representative in Haiti, Igor Bosc.

Women and families remain in desperate need of pre- and post-natal care. During Cindy's visit to Haiti in May 2010, her group, which consisted of three midwives and four nurses, saw 600 patients in just one week.  Through donations, Lane County Friends of the Birth Center assembled and sent 14 new mother kits with Cindy. These kits included blankets, cloth diapers, vitamins, and other items new mothers and their babies need.

On October 5, Cindy will share her experiences in the first Fireside Chat hosted by the Lane County Friends of the Birth Center. Members of the Eugene and Lane County community are welcome to attend. Refreshments will be provided.  For questions, contact lanecofbc@gmail.com.

When: Tuesday, October 5, 2010 at 7 pm
Where: Nurse Midwifery Birthing Services, 353 Deadmond Ferry Road, Springfield OR 97477 

Friday, August 6, 2010

The case for community approaches and Baby Friendly hospitals

Welcome to Friends of the Birth Center’s last blog post celebrating World Breastfeeding Week 2010 (WBW). Thank you for reading, forwarding, reposting and commenting on the week’s offerings. 

We especially appreciate Lane County Healthy Babies, Healthy Communities, the Lane County Breastfeeding Coalition and the American Association of Birth Centers for encouraging their members to follow and join our online celebration. We appreciate the opportunity to have health care providers and administrators hear about our WBW online celebration. Thank you, too, to The Register-Guard for the following August 1 mention:

Breastfeeding blog offered

Advocates of breastfeeding are observing World Breastfeeding Week, encouraging increased understanding and the adoption of evidence-based breastfeeding support systems for women, families and communities. A blog operated by Lane County Friends of the Birth Center offers various perspectives from families, elected leaders and others. Visit www.lanecofbc.blogspot.com for more information.

Making the case for Baby Friendly evidence-based support

Breastfeeding is a family and community affair. Friends of the Birth Center conveyed this by inviting a cross section of supportive perspectives for effectively supporting women, babies, families, employers and communities in breastfeeding initiation and maintenance. We agree with the Surgeon General that a community-wide approach is needed to reduce disparities among breastfeeding mothers and children of all backgrounds and to improve support for nursing women in their workplaces and communities.

Specifically, the week’s blog posts make the case for and encourage Lane County hospitals to adopt comprehensive, evidence-based breastfeeding support systems by becoming officially designated Baby Friendly facilities. 



Read the week's offerings
Senator Merkley: Breastfeeding Great Formula for Moms and Babies 

Simply put, breastfeeding provides a great ‘formula’ for healthier moms and babies.

Community Perspectives on Breastfeeding Support at the Birth Center
…the breastfeeding care we describe as lifeline-like is not magic or luck but rather the outcome of the Birth Center practicing comprehensive, evidence-based breastfeeding care.

A Provider’s Perspective on Baby Friendly Breastfeeding Care in Lane County
Everyday, I was humbled to see how complicated decisions around breastfeeding are and how much more than an individual woman’s preferences are involved.

Baby Connection: an innovative approach to transforming community breastfeeding services
Baby Connection experiments with altering current models of care while navigating resistance to change.

During WBW 2010, Science and Hollywood weighed in, too
The New York Times published “Breast Milk Sugars Give Infants a Protective Coat” describing some of the non-nutritive, non-digestible components of breast milk.

“We were astonished that milk had so much material that the infant couldn’t digest,” Dr. German said. “Finding that it selectively stimulates the growth of specific bacteria, which are in turn protective of the infant, let us see the genius of the strategy — mothers are recruiting another life-form to baby-sit their baby.”

Much remains to be learned (and unlearned) about breast milk, a fluid shaped by 200 million years of mammalian evolution. What do the scientists conclude?

… every component of milk probably has a special role. “It’s all there for a purpose, though we’re still figuring out what that purpose is,” Dr. Mills said. “So for God’s sake, please breast-feed.”
Meanwhile in the land of pop culture and celebrity buzz, actresses who breastfed put a little something together.... Try not to laugh - we dare you!




What's next?
We will continue to collect survey responses from women, partners, extended family members, friends, neighbors and community members who have received or are familiar with someone who as received evidence-based breastfeeding support at the PeaceHealth Nurse Midwifery Birth Center – Lane County’s only Baby Friendly designated facility.

In sharing our stories, we hope to help make Baby Friendly care baseline for all women and families in Lane County. Anonymous results from this survey will be shared with staff and administrators of Lane County hospitals. 






Thursday, August 5, 2010

Baby Connection: Innovative Breastfeeding Care



Welcome to our fourth day of special blog posts devoted to increasing evidence-based breastfeeding care in Lane County and in honor of World Breastfeeding Week 2010. The theme today is innovation. We have asked Desiree Nelson to talk about Baby Connection.



Baby Connection: an innovative approach to
transforming community breastfeeding services
By Desiree Nelson

A couple of weeks ago, Lane County Friends of the Birth Center asked me to guest blog on innovative approaches to bringing evidence-based breastfeeding care to Lane County.

Specifically, Friends asked me to talk about a collaborative project called Baby Connection that I helped found. I was pleased to learn that my perspective on evidence-based infant feeding would be added to those offered by an elected leader, consumers (families) and a former local provider. Collaborative approaches are essential, if we are to effectively support families and communities in increasing access to breastfeeding support systems that work.

So, it is with pleasure that I join Lane County Friends of the Birth Center in their local celebration of World Breastfeeding Week 2010 “Baby Friendly” by blogging about Baby Connection, an innovative evidence-based local practice.

Friends was kind enough to give me a few prompts….

What is Baby Connection?

Baby Connection is a weekly, drop in service where families are welcome to weigh their babies, access lactation experts and connect with other families. Weight certificates, baby photos, scrap booking, snacks and good conversation among moms, dads and grandparents happen at Baby Connection. Everyone is welcome.

What makes Baby Connection evidence based?
Baby Connection is step 10 of the Baby Friendly Hospital Initiative’s Ten Steps to Successful Breastfeeding for maternity service providers:

Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

Families who use the PeaceHealth Nurse Midwifery Birth Center receive step 10 in the form of its weekly baby clinic. 


In what ways is Baby Connection more than a “new parents’ cafĂ©”?
The Baby Connection model is a complex, multifaceted program. Put plainly, it provides regular, non-emergent healthcare worker to mother-infant support, as well as mother-to-mother and family-to-family support.

To the casual observer, it probably looks pretty simple to run and fun to attend. It’s not simple but it is fun. It’s fun because Baby Connection is a pleasant, supportive antidote to the challenges many families (and providers) encounter around infant feeding – challenges that include knowledge gaps and that frequently put cultural/social practices and biology at odds.

Baby Connection cannot “fix” these problems or challenges. Rather, it responds by providing sound and up-to-date infant feeding information and unconditional positive regard and assistance with problem solving as parents desire.


How is Baby Connection innovative?
Baby Connection experiments with altering current models of care while navigating resistance to change. It continuously creates and role models the simultaneous provider-family and family-to-family connections needed to effectively support breastfeeding.

How is Baby Connection funded?   
There is no funding for Baby Connection. Baby Connection is a collective gift given by lactation consultants, nurses and community members in the form of time, knowledge (nurses, lactation consultants) and labor (community members).


Special support is provided by Birth to Three. They host us weekly in their beautiful and spacious building. They also provide one staff member each week to Baby Connection. THANK YOU Birth to Three!


What does Baby Connection hope to achieve?
Through demonstration, Baby Connection acknowledges and responds to the unaddressed but entirely serviceable demand for evidence-based breastfeed support in this and other communities. Baby Connection hopes to encourage sound replication throughout the healthcare system. By sound, I mean evidence based.

You mean inside hospitals?
No, not necessarily. Baby Connection serves families who used different facilities. Hospitals could collaborate and, in the process, complete a step toward becoming officially designated Baby Friendly hospitals.

When and why did Baby Connection come into existence?
In 2007, Lane County learned it had a fetal-infant mortality rate that was the most serious in the state and among the most serious in the nation. The high rate of infant death was in part due to unsafe infant sleep practices. I contacted James McKenna, Phd, A Mother-Baby Sleep researcher at Notre Dame to assist our county. McKenna is an international SIDS expert. He reviewed Lane County’s fetal/infant mortality data, then, at no cost, came to Eugene, Oct. 2008, to give a presentation on Safe Infant Sleep. In addition he gave this recommendation to our county: 
Help socially at risk women breastfeed, sleep safely with their babies.

What does breastfeeding and safe sleep have to do with infant mortality?
This is a complex and important subject. Please contact Lane County Public Health officials for comprehensive information. Breastfeeding and consistent safe infant sleep practices both are known to prevent SIDS. Many other factors play important preventative roles.

You have a new role with WIC. Can you tell us a little bit about it in the context of Baby Connection?
I have taken a temporary position with Oregon State WIC, through September 30, 2010. My position: WIC Project Coordinator for the Improvement of Maternity Care Practices. (Read more about Desiree’s position with WIC.)

How can community leaders and health care providers learn more?
We regularly welcome visitors to observe staff roles, family activities, shadow expert Feeding Specialists and attend our weekly staff debrief. Interested parties can contact me at desiree.nelson@gmail.com

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If you or someone you know received Baby Friendly care at the Nurse Midwifery Birth Center, please complete this short online survey.



Wednesday, August 4, 2010

A Provider’s Perspective on Baby Friendly Breastfeeding Care in Lane County

Welcome to Lane County Friends of the Birth Center’s third blog post celebrating World Breastfeeding Week 2010. Our first post was by Sen. Jeff Merkley. Our second post invites mothers, fathers, extended family and friends to complete a short survey about the Birth Center’s evidence-based breastfeeding care. 


Today Janie Akerlund guest blogs about her more than two decades’ experience with breastfeeding as a mother, a WIC peer counselor, a nurse and a lactation consultant in Lane County. Formerly employed at the PeaceHealth Nurse Midwifery Birth Center, Janie is currently pursuing a PhD in Immunology at UC Denver/National Jewish Health Hospital. 


A Provider’s Perspective on 
Baby Friendly Breastfeeding Care in Lane County

It’s time for me to recertify as an International Board Certified Lactation Consultant. Sitting here amongst piles of breastfeeding literature, I am thinking back over the 20+ years since my lactation obsession began. When Friends of the Birth Center asked me to reflect on my experiences as a provider in a Baby Friendly facility – the PeaceHealth Nurse-Midwifery Birth Center, it seemed the perfect way to start preparing for the exam.

Baby Friendly facilities are officially designated hospitals and birth centers where women and families receive evidence-based care known to positively influence breastfeeding initiation, exclusivity and duration. The Baby-Friendly Hospital Initiative (BFHI) works with these facilities to implement comprehensive evidence-based practices referred to as “Ten Steps.” Over ten thousand birthing facilities around the world have achieved this designation, including 96 facilities in the US; the Nurse-Midwifery Birth Center was designated in 1997 as one of the first ten US facilities.

In the nearly 14 years since becoming a Baby Friendly facility, it is gratifying to note the maintenance of breastfeeding initiation rates and the increases in duration and especially in duration of exclusive breastfeeding that have occurred at the Nurse-Midwifery Birth Center. We can attribute these positive outcomes to our adherence to Baby Friendly basic care standards.

It is frustrating to still see the largely preventable difficulties experienced by women who deliver and initiate feeding inside most hospitals. Along with a newborn, these families bring home contradictory, confusing information about feeding. Before discharge, women and families come into contact with pediatricians, lactation consultants, obstetric nurses, postpartum nurses, neonatal nurses, nurse’s aids and the housekeeping staff. All have different opinions, levels of knowledge and degrees of experience regarding breastfeeding initiation.

Women and families routinely experience this informational chaos even at hospitals like Sacred Heart Medial Center and McKenzie-Willamette. These facilities practice some of the Ten Steps including written breastfeeding policies and 24-hr rooming-in. They also have excellent lactation consultants. In the absence of the additional evidence-based practices including consistent training across the healthcare team, these practices fall short. The Baby-Friendly Hospital Initiative works with facilities to identify and address gaps and inconsistent practices.

Personal experience – not a substitute for evidence-based breastfeeding management

Having nursed three children, I thought I knew all there was to know when in 1990 Lane County Women, Infants, and Children (WIC) asked me to participate in their pilot peer counseling program. This volunteer program provided training for WIC participants who were successfully breastfeeding so that they could provide phone support to WIC peers who were new to breastfeeding. I thought,  “You need breastfeeding training? Don’t you just decide to do it?”

After the first WIC training session, I realized I knew NOTHING and set about immediately to rectify the situation. I went through the LCC nursing program thinking I would surely learn all I needed to know to assist with birthing and breastfeeding. NOT! Here is the only reference to breastfeeding in my maternity nursing module:

I.               Breast feeding (sic)
a.     Advantages
b.     Disadvantages

II.             Bottle feeding
a.     Advantages
b.     Disadvantages

It was clear that I was on my own if I wanted further education in lactation. The more I learned, the more enthusiastic (aka annoying) I became. This was exciting! Breastfeeding reduces infant mortality! It prevents allergies, autoimmune disease and asthma as well as decreasing the incidence of a host of childhood diseases! It decreases the mother’s risk of breast cancer, decreases her postpartum bleeding and helps her more quickly return to her pre-pregnancy weight! Why is this all-natural-miracle “drug” not more widely appreciated? People must not know! I sure didn’t. I shall tell them! I naively thought that if women knew of the risks associated with artificial feeding they wouldn’t do it; surely they would see the value in breastfeeding. Right?

Working at the Nurse-Midwifery Birth Center I heard the stories of many, many women; those who didn’t want to try breastfeeding and those who truly wanted to nurse their babies, and all the women in between. Everyday, I was humbled to see how complicated decisions around breastfeeding are and how much more than an individual woman’s preferences are involved. It wasn’t and still isn’t a simple matter of individual choice.

Every woman I have worked with wanted the absolute best for her baby. Suggesting otherwise is an insensitive simplification. The majority of these women believed that breastfeeding was best but many of them made rational decisions to formula feed in line with the realities of their lives. Not because they wanted less for their babies but because in the absence of a supportive environment at home, at work and in the healthcare system it would have been virtually impossible for them to succeed. So, they expended their resources on more achievable goals. 

Eventually, I started talking to physicians and other health care colleagues about their training around breastfeeding. Aware of the inadequacy of my training, I was curious to know about their experiences. I wasn’t surprised to find that the majority, even pediatricians, had little or no formal education around breastfeeding. Fortunately, this is improving somewhat.

Well then, I thought, what we really need is a supportive environment; we need all health care providers, including the housekeeping staff, to be knowledgeable about how to help women succeed; we need employers and the community to understand what moms and babies need to make breastfeeding work. Piece of cake or chasing windmills? It’s a mixed bag.

A glimmer of hope: Baby Friendly Hospital Initiative

Around the time I was learning that I knew nothing, a small group of neonatal health care providers in San Diego went to a course on lactation physiology. They came away realizing that much of the care they were providing in the mother-baby wards was not evidence-based and was counterproductive to successful breastfeeding. They had a series of meetings where they laid out a policy with ten simple guidelines to bring their mother-baby care in line with lactation physiology and the developmental capabilities of the newborn infant.

These ten simple steps have been adopted by the World Health Organization (WHO) as the standard of care for all mothers and babies; they were intentionally conceived so that any hospital, whether in an industrialized nation or a developing nation, urban or rural, rich or poor, could achieve them. Ten Steps is backed by a fully referenced 109-page document containing the best evidence available from peer-reviewed journals.

I brag a lot about the Nurse-Midwifery Birth Center’s BFHI designation and the high rates of breastfeeding we see there – “best of the best of the best, SIR!” Perhaps our exuberance plays into the frequent dismissal that these excellent outcomes can be attributed to the special, self-selected group of birth center moms. Of course, I agree they are special, but no more so than any other mom and family in Lane County.

Besides, these dismissals overlook the fact that Birth Center moms are a representative cross section of Lane County. They come from all walks of life; ages 14 to 46 from the ivory tower professor to the fast food restaurant worker to the inpatient at Willamette Family Treatment Center. Every one of these women receives consistent standard Ten Step care. I believe our outcomes are best understood as indicative of the model, one that can be replicated.

Fortunately, awareness of the efficacy of providing evidence-based breastfeeding care is rising. The special supplemental nutrition program for Oregon WIC has recognized the importance of evidence-based care in hiring Desiree Nelson, a Lane County lactation consultant with BFHI expertise, to be an available resource to support Oregon hospitals to improve breastfeeding practices; the Joint Commission for the Accreditation of Hospitals Organization (JCAHO) is now monitoring breastfeeding exclusivity outcomes at discharge as a part of their periodic hospital assessment; the CDC recently surveyed all birthing facilities on their level of breastfeeding support through the 2007 CDC National Survey of Maternity Practices in Infant Nutrition and Care (mPINC). (Oregon nPINC results)

In light of these shifts in understanding and, hopefully, priorities, hospitals will need a comprehensive plan to meet the standards of their accrediting bodies, governmental organizations and consumers. BFHI provides these tools and the clearest pathway forward to implementing comprehensive evidence-based care in the form of the “Ten Steps.”

I challenge Sacred Heart Medical Center, Peace Harbor Hospital and McKenzie Willamette Hospital to partner in providing 100% of Lane County’s hospital-born babies with comprehensive evidence-based breastfeeding care through implementation of the Ten Steps to Successful Breastfeeding.

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Contact Janie at Linda.Akerlund@ucdenver.edu

Comments welcome - feel free to post below!

And, please share your experience with Baby Friendly care at the Nurse Midwifery Birth Center by completing a short online survey. Click here

Tuesday, August 3, 2010

Community Perspectives on Breastfeeding Support at the Birth Center

Welcome to our second blog post celebrating World Breastfeeding Week 2010. Yesterday, U.S. Senator Jeff Merkley guest blogged about the importance of supporting mothers and babies to breastfeed. Today, we invite women, families and the community to share their experiences with the lactation services available at the PeaceHealth Nurse Midwifery Birth Center by completing an online survey. Tomorrow, Janie Akerlund guest blogs about her more than two decades’ experience working as a nurse and lactation consultant in Lane County.

Baby Friendly care at the 
Nurse Midwifery Birth Center

A year and a half ago, the future of the PeaceHealth Nurse Midwifery Birth Center was uncertain. PeaceHealth and the community worked together to clear obstacles and Lane County enjoys ongoing access to a new and beautiful freestanding, out-of-hospital birth center. (Take a virtual tour of the new facility.)

Before the Birth Center’s future was secure, families and community members reflected on what its absence would mean. In our letters and petition comments, many of us emphasized the critical role Birth Center lactation services play in initiating and maintaining breastfeeding.

We have since learned that the breastfeeding care we describe as lifeline-like is not magic or luck but rather the outcome of the Birth Center practicing comprehensive, evidence-based breastfeeding care. Specifically, the Birth Center practices the “Ten Steps to Successful Breastfeeding” and is officially designated "Baby Friendly" by the Baby Friendly Hospital Initiative.

To celebrate World Breastfeeding Week, Friends of the Birth Center invites parents, extended family members, friends and supporters to share their experiences with Baby Friendly care via an online survey. Our perspectives, as recipients of this critical care, can encourage Lane County maternity service providers to make Baby Friendly baseline for everyone. Anonymous results will be shared with staff and administrators of Lane County hospitals.




Breastfeeding is a family and community affair. Convey this by having your partners, extended family and friends respond to the survey by August 17, 2010.

In the mean time, here’s what community members had to say about evidence-based Baby Friendly care at the Birth Center in 2009:

Mother
Both breastfeeding and transitioning into being a parent were a lot more difficult than I anticipated and the caring and compassionate staff at the Birth Center helped me through it.

When our daughter was about 3 weeks old, I started to have problems with breastfeeding. She wasn’t getting enough milk and therefore wasn’t gaining enough weight. It was a very scary and frustrating time. Through the constant support of the lactation nurses, we have been able to continue breastfeeding through her first birthday! If it weren’t for their unfailing support, we wouldn’t have made it to through her fourth week.

Father
We had various challenges after delivery with the establishment of nursing, and the lactation consultants were always there for us in person or via phone to listen and offer advice. They even met us on weekends and holidays to allow us to track our son’s weight. There were times when I thought we might give up on trying to breastfeed our son, but after many weeks, my wife and son were finally successful at nursing. I attribute this in a large part to the staff at the Birth Center and the support we received from them.

Grandmother
The follow up by the Birth Center after my granddaughter’s birth has been more than I could have ever dreamed of having. I have gone with my daughter and granddaughter for a weekly “check in” at Baby Clinic. You can’t put a price tag on how important that kind of support is for a new mother. In the waiting room are mothers, fathers, and babies of all sizes.

Mother
My first birth was an unsatisfying high-tech, low-touch experience that left me dazed and, ultimately, deeply dissatisfied. Recovering from surgical birth was not easy especially as I mightily struggled to initiate breastfeeding and establish myself as a mother for the first time. My obstetrician’s practice employed a lactation consultant but she was hard to reach, pressed for time and, in the end, not helpful despite my repeated calls. Following my first son’s birth, I felt alone without anyone knowledgeable in breastfeeding and infant care with whom to check in.

I had my second son, a vaginal birth after cesarean, with the Birth Center. Watching first-time moms receive the Birth Center’s breastfeeding services as a matter of course was revelatory – this is how it’s supposed to be! Receiving this care the second time was wonderful and life altering as I not only thrived and enjoyed initiating breastfeeding the second time but loved doing it an community of other women where help from a friend or a provider was always within reach.

Grandmother
My daughter gave birth in July at the birthing center.  The midwife and the lactation specialists were incredibly encouraging, kind, & informative to my daughter as well as the rest of us in the room.  Following the birth, my daughter continued to ask many questions about breastfeeding for several weeks.  The lactation consultants always took their time listening to her concerns.  Without their encouragement, I am doubtful that she would have been able to continue breastfeeding.  Also the baby clinic was a wonderful way to check her baby's progress and connect with other mothers.  Having a baby and the follow-up she received was a far superior method of having a child than what I experienced long ago in the hospital with my births.  I can't imagine Eugene without this center. 

Mother
The Birth Center also provided me with the support I needed to continue breastfeeding my newborn through the first few difficult days. I made many friends on Tuesdays in the lobby of the Birth Center that first year.

Mother
… the excellent after care that I received at the Birth Center and the expert lactation advice that gave me the sense that the consultant was always there for me when I needed to call with questions and concerns. She knew me. She cared consistently and she never tired or expressed anything other than hope.

The Birth Center is such a special place for my family and me. They know me and my child by name. The Birth Center has been a great place to meet other moms and families through the birthing classes offered and the weekly baby clinics. We have made strong and lasting connections that strengthen our abilities to be the best parents that we can be.

Friend of mother
… delivery went smoothly but there were nursing difficulties. Within a half-hour of birth, the midwife and her assistant were providing information and assistance which were key to the nursing process, and which in my experience are rarely available in larger hospital settings.

Mother
My husband and I received education and information through the prenatal visits, the breast feeding class and child birth classes, that allowed us to make educated decisions about what was best for us and our baby.

The follow up care from the first home visit to the many consults with the lactation consultants, to the numerous visits to the baby clinic, have provided me with continued support to successfully nurse my baby (even through teething!).

Mother
I was allowed to hold my daughter, skin-to-skin, from the moment she was born. There was no pressure to breastfeed immediately or bathe her before I was ready too. I, personally, had problems with breastfeeding and they help my daughter and I figure it out without me feeling like I was failing as a mother.

Mother
My husband and I attended birth classes at the center, and found them valuable even as second-time parents. I have since visited the free baby clinic numerous times for information, support, and camaraderie with other mothers. I can honestly say that without the baby clinic and on-call lactation specialists, I would not have breast-fed my son past the first month. He is now 9 months old and I feel confidant and comfortable breast feeding at least to his first birthday, which was a personal goal of mine. I credit the supportive staff and community atmosphere of the birth center in making this possible.

Mother
My son thrived, but I continued to go to the well-baby clinic for the reassurance of tracking his growth and the camaraderie of the other new mothers.

Mother and father
We even called for support from the Birth Center lactation consultant in the middle of the night while we were still in the hospital and she made all the difference in easing our worries.

Our favorite aspect of the Birth Center has been the weekly baby clinic. My family has found the baby clinic invaluable for lactation support as well as helping enhance our sense of community with our fellow new parents.

We are again enjoying the benefits of the baby clinic and have recommended the Birth Center to many friends.

Mother
After our baby was born, I had an amazing experience of holding him on my chest for two hours. Annie took care of all the members of our growing family and checked on us throughout the night. We went home at 7am to start our new life with a baby. She noted we were having some difficulties with nursing, but gave me some suggestions of how to assist him in learning this important first skill.

I was recovering well from delivery, but we were continuing to have difficulties with breastfeeding. This visit started a very close and important relationship for our family with Hope and the other lactation consultants at the Birth Center.

Over the next 8 weeks, we visited the Birth Center (and Hope or Annie) at least twice a week to weigh our son, who slowly started to learn how to nurse and gain weight. Hope called me at home over the Thanksgiving and Christmas holidays (and many other times) to check on how we were doing. On several occasions, I also talked to the other lactation consultants, Annie and Janie, on the phone with a variety of concerns.

Each time I called with a new problem (often in tears), I felt that my concerns were treated with the utmost respect and concern. Ultimately with their wonderful care and support, we were able to determine the causes of my nursing problems and associated pain and find ways to resolve the problems.

Hope, Annie, and Jude never gave up on finding solutions for me. They suggested books to read, lactation tools to try, and foods to eat. Hope recommended that we visit Tuesday Baby Clinic to meet and talk with other Mamas.

Every Tuesday, I felt that I was wrapped in a new community that cared about me, my husband, and our son. This community encouraged us even on the most difficult days when it felt like I would never be able to breastfeed.

I had always envisioned myself breastfeeding my children. One day, almost magically, when our son was four months old, nursing stopped hurting, and we were able to nurse just like I had imagined. Nursing is a skill that he has perfected, and now, one year later it is hard to image all of the problems that we had with our rough start. However, I do remember that I could not have continued learning how to breastfeed and survive the early weeks of motherhood without the love and support that I received from the staff of the Birth Center.

In an era where families are scattered around the globe and women do not share in the common experiences of pregnancy, childbirth, and breastfeeding with their female relatives, we need places like the Birth Center.

Mother
After the birth, I continued to discover the uniqueness of the services at the birth center. I had heard about baby clinic during my consultation with Hope, the lactation consultant, and when my daughter was three weeks old I brought her to baby clinic for the first time. The benefits of baby clinic were two fold. For one, I got incredible ongoing breastfeeding support from the nurses and assurance that my daughter was indeed thriving. The simple 5 minute visit each week put my mind at ease to all of the little worries I was having about caring for my newborn.

Additionally, knowing that I could call a nurse 24 hours a day and receive breastfeeding support made me feel at ease. I was never fearful of a middle of the night incident sending me over the edge because I knew help was always available.

The second benefit of baby clinic is perhaps even greater than the first and that is the community that is created each week in the living room of the birth center. Mothers come together and talk, share, and support one another. Any topic related to new motherhood, newborns, or postpartum experiences is open for discussion.

The first time I went I felt right at home with all of the other breastfeeding mothers. In those early weeks of motherhood and breastfeeding it saved my sanity to have a place I could go and be with other nursing mothers who were also learning how to breastfeed our babies.

I quickly made friends with a few other new moms. I looked forward to seeing them each Tuesday and I am convinced that this support network is a big reason that I did not experience any postpartum depression. It is almost a year since my daughter’s birth and I am still close friends with many of the women I bonded with at baby clinic.

I chose the birth center because the midwives and staff are committed to natural birth and it is one of the only places in our community that natural birth is fully supported on a daily basis. The pre and postnatal care in connection with the community of support makes the Nurse Midwifery

Monday, August 2, 2010

Senator Merkley: Breastfeeding Great Formula for Moms and Babies

Celebrating World Breastfeeding Week

By Senator Jeff Merkley



Today marks the first day of World Breastfeeding Week - a week where people come together to raise awareness about the health benefits of breastfeeding and to promote the rights of nursing moms around the globe. 

Breastfeeding provides proven health benefits for both babies and moms, while at the same time increasing productivity for businesses.  Studies have shown that children who are breastfed have lower risks of diseases and illnesses including asthma, diabetes, obesity, and certain cancers.  New moms who breastfeed also have reduced rates of cancer and diabetes.  Simply put, breastfeeding provides a great ‘formula’ for healthier moms and babies.

This year we took a significant stride forward to help support nursing moms across America.  The 2010 health care law includes an amendment I authored that provides nursing moms with reasonable break times and a private place to pump milk in the workplace.  This may be old news in Oregon, where these protections have been in place since 2008, but enacting similar national legislation greatly enhances breastfeeding opportunities for all of our nation’s mothers.

Through events like World Breastfeeding Week and with the help of organizations like Lane County Friends of the Birth Center, we can accomplish a great deal for new moms.  It’s important to continue to work together to ensure that nursing moms around the world have every opportunity available to provide healthy breast milk for their new babies.

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Click here to communicate with Sen. Merkley.

Read more about Lane County Friends of the Birth Center's World Breastfeeding Week Celebration and come back for tomorrow's post: 
Read what families have to say about accessing lactation services in a Baby Friendly facility – the PeaceHealth Nurse Midwifery Birth Center. LaneCoFBC will invite more families to share their perspectives via an online survey. Findings will be shared with local healthcare facilities and community leaders.