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’ café”?

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

###

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

Too many Lane County babies dying

Before Thanksgiving, the Register-Guard published Tracking infant mortality | Why is the rate so high in the United States? This editorial explores the connection between inadequate health care and the nation's high infant mortality rate. According to the CDC and as reported in the New York Times, the United States trails 29 nations, tying with Poland and Slovakia, in infant mortality.

Some of the reasons for high infant mortality in the United States include:

• High rates of premature birth
• Excessive use of cesarean section and labor-induction drug
• Lack of health care and social support, particularly among poor and minority women
• Infertility treatment practices
  

While the Register-Guard has covered Lane County’s unbelievably high rate of fetal-infant mortality in the past, no mention was made in this editorial. The following opinion piece was submitted by Katharine Gallagher, member of Lane County Friends of the Birth Center, and published on December 6th. The quoted rate of 9.5 deaths per 1,000 births should have been identified by Katharine as the fetal-infant mortality rate, which includes both fetal (24 weeks gestation and 500 grams) and infant deaths (through the first year of life). This rate was incorrectly identified as the infant mortality rate, which includes only infant deaths.

Too many Lane County babies dying | The infant mortality rate here is higher than it is statewide, nationwide and in Poland and Slovakia
By Katharine Gallagher
For The Register-Guard
Appeared in print: Sunday, Dec 6, 2009

Readers of The Register-Guard’s Nov. 25 editorial “Tracking infant mortality: Why is the rate so high in the United States?” may have been surprised to learn that the United States ranks 29th among nations for infant mortality — tying with Poland and Slovakia, and trailing countries of considerably lesser means. These readers will be shocked to learn that Lane County’s most recent 2007 infant mortality rate (9.5 per 1,000 live births) is higher than the mediocre rates in Multnomah (7.4 per 1,000), Clackamas (6.7) and Washington (6.4) counties; higher than that of Oregon statewide (7.9), and higher even than U.S. rates (9.3).

Put another way, babies born in Lane County start life at greater risk than they would in Poland or Slovakia. Why is the infant mortality rate so high here? More importantly, what are we doing about it?

While national infant mortality rates are a compelling indicator of the health care system’s failures, limiting our consideration to the national context suggests we can wait for federal policymakers to make things better. This is shortsighted.

Infant mortality rates have long been accepted as the most sensitive indicator of a community’s overall health, as well as a barometer of social and economic well-being. The death of an infant is a seminal event demanding a ground-level examination of the resources available to local health and human service departments and their capacity to effectively deploy them. Equally important, it is a call for civic engagement.

After more than a decade of too-high avoidable fetal and infant mortality rates, we need a new approach. The Lane County Public Health Department recently established the Healthy Babies, Healthy Community Initiative to encourage a community-led response among public, private and nonprofit organizations, researchers and community members. Initiative participants support adopting a local Fetal Infant Mortality Review Program. FIMR is a national network of community-based, action-oriented programs with a record of success.

The goals of the FIMR program are to support grieving mothers and to prevent avoidable future mortalities. When a fetal or infant death occurs, FIMR is notified. If the mother is willing, she participates in an interview with qualified professionals. Mothers’ stories help renew local commitment to finding and solving community-specific problems contributing to infant mortality. Most importantly, FIMR puts mothers and families in touch with professionals able to provide bereavement support.

Once family needs are being met, prevention moves to the forefront. Information is collected and analyzed. Sources of data — stripped of information that identifies the family, health care providers and institutions — include the mother’s interview, medical records, birth and death certificates, coroner’s reports, and records from health and social service agencies. A qualified case review team identifies the most prevalent factors and makes recommendations for improvements. Participants in the Healthy Babies, Healthy Communities Initiative would then translate these recommendations into a transparent, systematic community action plan and implement it.

The initiative anticipates receiving results of the first data analysis of fetal and infant mortalities from the Lane County Public Health Department after the New Year.

Analyzed data is essential to understanding our current local context. Are the infants we lose born at term? Do they survive past the critical first month? What is the mother’s age? What kind of support did she receive before, during and after giving birth?

With this information, we can act to reduce fetal and infant mortality. Without it, we are operating in the dark, facing another decade of avoidable tragedy.

Lane County’s fetal and infant mortality rates are not set in stone. We can, we must, insist that avoidable mortalities occurring in our midst cease. The Healthy Babies, Healthy Community Initiative is a positive development. To meet its potential, it must have a funded, functioning FIMR program. Since 2007, the $150,000 FIMR funding request to facilitate data analysis and case review has gone unanswered.

Elected officials, civic leaders, and community members have demonstrated the collaborative action necessary to build state-of-the-art courthouses, hospitals, stadiums and athlete learning centers. When we see this same level of commitment directed toward solving the problem of fetal and infant mortality, we will begin charting a better course for our most vulnerable babies and families. Financially, the funding requirements are a pittance compared to the costs of these new facilities. The return on investment, however, is beyond compare.