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Early Interventions Result in High Breast-feeding Rates at UCSF

March 29, 2011
News Office: Karin Rush-Monroe (415) 502-6397

UCSF Benioff Children's Hospital has one of the highest rates of exclusive breast-feeding in the state of California, according to a report by the UC Davis Human Lactation Center and the California WIC Association.

The report titled, "One Hospital at a Time: Overcoming Barriers to Breast-feeding," ranks UCSF number four out of hospitals throughout California based on their rates of exclusive breast-feeding, when the infant only receives breast milk. At UCSF Benioff Children's Hospital, 88.7 percent of mothers exclusively breast-fed their newborns, according to the report that cites 2009 data.

It also concludes that California hospitals need policies that support breast-feeding mothers to give children the best chance at good health from birth.

"The health benefits of breast-feeding are above and beyond anything else," said Dawn Reidy, who is certified by the International Board of Lactation Consultant Examiners (IBCLC) and is coordinator of lactation services at UCSF. "It really is the first step in preventative care for a child."

UCSF lactation specialists and experts have been building a robust lactation service for the last 15 years, implementing a lactation task force, hiring certified lactation consultants and educating obstetricians, pediatricians, residents and nurses to create a climate of support that is passed down to the patient.

"The medical center has supported a cadre of nurses who are lactation certified and that is their primary job, to provide breast-feeding support and intervention to every mother," said Dr. Carol Miller, clinical professor of pediatrics and medical director of the Well Newborn Nursery. "In addition, that same group has taken on the job of providing education for all of the nurses, so even the staff nurses are at least able to help mothers get started and clued into our philosophy and support so when things get challenging they don't go straight to the bottle."

Reidy tries to see all babies and mothers during the first 24 hours of life, educating them and addressing concerns. "It gives them an idea of what they should be feeling and look out for," she said. "It's a concerted team effort all around. The nurses, obstetricians and midwives are an essential team. If a baby can nurse in the first two hours of life, the likelihood of ongoing success is much higher."

All of the nurses are trained in breast-feeding assistance and all new nurses spend a day following a lactation specialist, a certification that requires more than 1,000 hours working with individual breast-feeding moms and babies. Residents in obstetrics and pediatrics must attend a lecture on breast-feeding and the intensive care nursery is staffed with its own lactation consultant.

That education is passed on to expectant mothers starting with their prenatal visits. "We work to get the mothers engaged in wanting to breast-feed, which has to happen prenatally, and certainly we have a very supportive [obstetrics] group that has embraced that concept," said Miller. "We encourage women to breast-feed with information about how important it is, with benefits to not just the baby but the mother."

Lactation specialist Dawn Reidy meets with new moms within 24 hours of delivery to answer questions and provide breast-feeding support.

Breast-feeding is widely considered one of the most important preventative care measures for children's health, reducing risk for infections and chronic diseases including diabetes, asthma and obesity. It also reduces the mother's risk for type 2 diabetes and breast and ovarian cancers.

"Breast-feeding was supported from the beginning of my pregnancy and immediately after delivery, without having to ask for more information," said Aimee Sznewajs, a fourth-year UCSF medical student who delivered baby Leo this month.

Her husband Anders Persson, an assistant adjunct professor of neurology and researcher in the Weiss Lab at the UCSF Mission Bay campus agrees. "The staff has been amazing all the way through. All of the people coming in make us feel really safe and supported."

Several forums are available to expectant and new mothers, including prenatal classes and one-on-one visits with lactation consultants. Established in 2005, the lactation task force oversees the coordination of all of these inpatient and outpatient efforts and protocols to create a continuity of care and philosophy.

"The task force provides a linkage with outside lactation consultants, provides prenatal courses and keeps abreast of research in lactation," said Sharon Wiener, a certified nurse midwife at UCSF Women's Health Center and a leader of the Lactation Task Force Committee.

The group meets once a month to "problem shoot, come to a consensus in our program, intervention and research," said Miller, the other task force leader. "We've created several forums to get mothers engaged so when they come to deliver they're receptive and we try to build on that."

The ongoing efforts are paying off, reflected both in the statewide ranking and in the experience in the hospital. "We're very proud to see the rates are at the high levels they are," said Miller. "We've worked really hard on this and it's about this culture we're creating and sustaining."

About UCSF Medical Center

UCSF Medical Center consistently ranks as one of the top 10 hospitals in the United States. Recognized for innovative treatments, advanced technology, collaboration among health care professionals and scientists, and a highly compassionate patient care team, UCSF Medical Center serves as the academic medical center of the University of California, San Francisco. The medical center's nationally preeminent programs include children's health, the brain and nervous system, organ transplantation, women's health and cancer. It operates as a self-supporting enterprise within UCSF and generates its own revenues to cover the operating costs of providing patient care.

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