FIRST STEPS Improving Practices Supportive of Breastfeeding in Ohio Hospitals

Health Organization and Baby-Friendly Free trainings across the state have RECOGNIZED HOSPITALS (DEC. 2018) Launched in 2015, USA. The Ohio First Steps for Healthy reached have reached hundreds of hospital RESULTS This list can also be found at Ohio First Steps for Health Babies is led Babies program recognizes hospitals for staff, accounting for nearly all maternity ohiohospitals.org/firststepshospitals. jointly by the Ohio Hospital Association implementing the Ten Steps, using a hospitals in Ohio. Currently, 98% of and the Ohio Department of Health. The modified application form. A five-star maternity hospitals are engaged in the OHIO DEPT. STEPS MOST APPLIED FOR Over 98% of maternity hospitals in Ohio are program recognizes maternity centers in program, First Steps awards a star for First Steps program, and outreach is OF HEALTH engaged in the First Steps program. Since Ohio that have taken steps to promote, every two steps achieved. taking place to reach the remaining few STEP 8 STEP 10 93 87 STEP 4 STEP 1 program launch, over half of the hospitals protect and support breastfeeding in their facilities. Preliminary data analyses appear Our 2017 Vital Statistics PERCENT PERCENT 80 PERCENT PERCENT77 involved have advanced in steps achieved. organizations. First Steps offers many Since the program has been implemented, to indicate that the First Steps program is exclusive breastfeeding opportunities for learning and networking dozens of original educational resources having an impact in improving rate at hospital to support the Ten Steps to Successful have been created, with thousands of breastfeeding rates in Ohio hospitals. discharge STEPS LEAST APPLIED FOR Breastfeeding, as defined by the World copies being distributed across the state. is: STEP 3 STEP 9 Atrium Medical Center—Premier Health Mount Carmel West PERCENT75.6 63 64 Aultman Orrville Hospital Mount Carmel St. Ann’s STEP 6 PERCENT PERCENT Akron General* OhioHealth Doctors Hospital* STEP 2 Cleveland Clinic Fairview Hospital* OhioHealth O’Bleness Hospital* PERCENT48 Cleveland Clinic Hillcrest Hospital* St. Luke’s Hospital PERCENT40 Licking Memorial Hospital* Southview Medical Center— HIGHLIGHTS Mercy Health Anderson Hospital Summa Akron City Hospital* Mercy Health Fairfield Hospital University Hospitals Elyria Medical Center* Mercy Health—West Hospital University Hospitals MacDonald Who is included in mPINC surveys? —Premier Health Women’s Hospital* TOTAL mPINC SCORES Every other year, CDC invites all Miami Valley Hospital South—Premier Health University of Cincinnati Medical Center* Created educational materials on benefits of breastfeeding Maintains a Resource Guide Mount Carmel East Upper Valley Medical Center—Premier Health FOR OHIO HOSPITALS maternity hospitals* nationwide and the 10 steps. Distributed thousands of free copies of that lives on the OHA and ODH to participate in mPINC. In 2015, 802015 83% of eligible Ohio hospitals took 76 survey materials across the state. webpages, 2013 part. (n=90) 7 71 survey 69 2011 hosting various 67 2009 survey 2007 survey survey What does mPINC measure? Adena Regional Medical Center OhioHealth Dublin Methodist Hospital Breastfeeding Breastfeeding Breastfeeding resources for Survey questions measure infant feeding care The Christ Hospital Medical Center— OhioHealth Riverside Methodist Hospital for the Best Feeding! for the Best Feeding! Hosted seven free TAKING THE FIRST STEPS FOR HEALTHY BABIES & Safe Sleep practices, policies, and staffing expectations in TEN STEPS TO SUCCESSFUL BREASTFEEDING What is mPINC? mPINC is CDC’s national survey of maternity Liberty Campus ProMedica Defiance Regional Hospital Both work together to lower your baby’s risk hospital staff on of Sudden Infant Death Syndrome (SIDS) educational place at hospitals that provide maternity services. Firelands Regional Medical Center Soin Medical Center breastfeeding practices in infant nutrition and care. Galion Community Hospital University Hospitals Portage Medical Center Breastfeeding • Your milk gives nutrients to your baby and helps keep them happy and healthy. webinars on topics Breastfeeding It is great for your health too! Holzer Medical Center University Hospitals St. John Medical Center • Formula fed babies are more at risk for SIDS. FOR THE BEST FEEDING • It is best to give only breastmilk for the first 6 months. Continuing to breastfeed to and working Kettering Medical Center West Chester Medical Center—UC Health 12 months and beyond (with foods added at 6 months) extends the many great benefits. Resource Guide • Giving your baby a pacifier can reduce the risk of SIDS, but you should wait to use a including: Data BREASTFEEDING BENEFITS ROOMING IN pacifier until you and your baby are comfortable with breastfeeding. Links and tools to support the First Steps for Healthy Babies initiative and your hospital’s breastfeeding journey. Lima Memorial Hospital Great for baby Rooming in so you and your baby can stay Healthy nutrients and disease protection together all the time towards Baby Easier to digest Parents learn baby’s feeding cues Lowers risk of ear infections, asthma, respiratory infections and diarrhea Baby learns to recognize mom, sleeps better and cries less Protects against obesity and SIDS Parents learn how to care for baby with staff nearby to help Safe Sleep Collection, Disparities, First Steps Ten Steps flipchart 2016.indd 1 9/9/16 11:42 AM Baby will have more chances to learn to breastfeed Great for mom • Always place your baby on his or her back for all sleep times - naps and night, until their Lower risk for breast and ovarian cancer, diabetes and heart disease 1st birthday. Promotes bonding supports moms and families who choose to • Place your baby in a crib, bassinet, portable crib, or play yard with a firm mattress and Friendly breastfeed their new baby. We are partnering with tight fitting sheet. FUTURE PLANS EXCLUSIVE BREASTFEEDING BABY FEEDING CUES (SIGNS)Ohio’s First Steps for Healthy Babies program to • Do not use pillows, blankets, soft toys, or crib bumpers anywhere in your baby’s sleep Fatherhood/Partner area. Dress baby in a sleep sack or pajamas to match the temperature of the room. EARLY CUES MID CUES LATE CUES CALMING “I’m ready “Don’t delay, “Calm me, A CRYING Give only breastmilk for the first six months, to feed.” feed me, please!” then feed me.” Feed your babypromote as often and the long “10 as baby Steps shows to Successful Breastfeeding.” BABY • Do not smoke or let anyone smoke around your baby. This can increase the risk of SIDS. with no additional foods or liquids. • Cuddling signs of being hungry • Skin-to-skin contact on chest Allow the baby, not the clock, to guide feeding. Look for cues of hunger • Stirring • Stretching • Crying • Talking Stirring, mouth opening, turning head, sucking hands and rooting designation. Continue breastfeeding for 12 months and • Stroking for food beyond to extend the benefits • Singing/ humming • Gently Let the baby end the feed by falling asleep when full Breastmilk has all the nutrients your baby needs • Mouth opening • Increasing motion • Agitated motions rocking Promotes a good milk supply Engagement, Step 3, Feeding other foods too soon can cause digestive problems • Putting your warm Baby’s hunger is satisfied Provides health benefits to mother and baby cheek next Share the room, not the bed to baby’s • Turning head • Hand to mouth • Color turning red head • Seeking/rooting • Breastfeeding helps you bond with your baby. Being near your baby can help you learn • Expanding Maternity Best • Further sharing and • Leveraging new data signs for when baby is hungry and helps support breastfeeding. SKIN-TO-SKIN LATCH AND POSITIONING • Room share—keep baby’s safe sleep space in your room for at least 6 months. and other best Skin-to-skin is best for your baby! Proper latch and positioning are important to • You can breastfeed baby in your own bed. When finished feeding, put your baby back into Keeps the baby warm and calm breastfeeding his or her own separate safe sleep space, within view and reach from where you sleep. Berger Health System OhioHealth Grady Memorial Hospital Better oxygen and blood sugar levels for your baby Mother and baby should be comfortable while breastfeeding Good for bonding Care Practice Awards collaboration through metrics and incorporating Deep latch ensures baby gets enough milk and mom feels tugging, not pain Helps with breastfeeding Baby’s knees face mom’s tummy to prevent pulling on nipple The Christ Hospital—Mt. Auburn OhioHealth Helps you learn the feeding cues for baby-led feeding Good latch prevents nipple soreness Frequent feeding helps develop a good milk supply Don’t be afraid to ask for help practices Birthing Center OhioHealth Mansfield Hospital statewide education and quality improvement

First Steps Ten Steps poster 2016.indd 1 8/18/16 12:33 PM • Recruiting more hospitals Clinton Memorial Hospital OhioHealth Marion General Hospital networking practices Community Hospitals & Wellness Centers— ProMedica Bay Park Hospital and reaching more partners Bryan Hospital ProMedica Flower Hospital Fulton County Health Center ProMedica Memorial Hospital Lake Health TriPoint Medical Center ProMedica Toledo Hospital Hosted free Kangaroo Care Lake Health West Medical Center Southwest General Health Center Created the Maternity Care Best Practice Memorial Health St. Elizabeth Boardman Hospital recognition for hospitals that did not provide 30 trainings across the state of Mercy Medical Center St. Rita’s Medical Center WORKSHOPS Ohio through ODH. In addition, ACKNOWLEDGEMENTS Mercy Regional Medical Center Wilson Health free formula to new mothers in partnership REACHING OVER Mercy Health St. Charles Hospital Wooster Community Hospital 73 400 hosted 19 free train-the-trainer Mercy Tiffin Hospital with the Ohio Lactation Consultants HOSPITAL STAFF Ohio First Steps Staff Ohio First Steps Expert Review Team Ohio First Steps sessions across Ohio in support Association and Ohio Breastfeeding Alliance. FROM OVER 90% OF Partners of Step 2, staff education and Ryan Everett, MPH Jennifer Foster, BSN, RN, IBCLC In its third year, this recognized 73 hospitals for their best OHIO’S MATERNITY Director, Population Health Summa Health System Ohio Lactation Ohio Hospital Association practices. An increase of 40% from year one. HOSPITALS skills labs. Lydia Furman, MD Consultants Association Fairfield Medical Center St. Joseph Warren Hospital Bre Haviland, MS, RD, LD, CLC University Hospitals Rainbow Babies and Children’s Hospital Ohio Breastfeeding Joint Township District Memorial Hospital Summa Barberton Hospital Bureau of Maternal, Child and Laura Knisley, MSN, APRN, RD, LD, FNP, IBCLC, CDE Alliance Knox Community Hospital University Hospitals Geauga Medical Center Family Health Ohio Lactation Consultant Association MetroHealth Medical Center Wood County Hospital Ohio Department of Health Association of State Mercer Health Wright-Patterson Medical Center Awarded 2018 Best Abstract Award in Mary (Libby) Svoboda, MEd, BSN, RN, IBCLC, FACCE and Territorial Health Pomerene Hospital Education, Quality Improvement, or Advocacy University Hospitals MacDonald Women’s Hospital Officials Julie Ware, MD, MPH, IBCLC Ohio Chapter, American by the American Academy of Pediatrics Section on In 2018, in support of the Step 2 focus on staff education, ODH Cincinnati Children’s Hospital Medical Center Academy of Pediatrics Breastfeeding. Abstract titled “Ohio First Steps for launched 15 online modules on behalf of First Steps. Hospital Healthy Babies—impact of a state-based program staff can complete these at their own pace and receive continuing Ashtabula County Medical Center Southeastern Regional Medical Center 155 E. Broad St., Suite 301 • Columbus, OH 43215-3640 Union Hospital to promote best breastfeeding practices for birthing Blanchard Valley Health System University Hospitals Parma Medical Center education, all at no cost. t 614.221.7614 • f 614.221.4771 Henry County Hospital Wayne HealthCare hospitals”, submitted by lead author Lydia Furman, MD. Mary Rutan Hospital ohiohospitals.org : /helpingohiohospitals : @ohiohospitals

*Baby-Friendly USA Designated Hospital