08:52am Saturday 30 May 2020

Early Interventions Result in High Rates for Breastfeeding at UCSF Benioff Children's Hospital

New parents Anders Persson and Aimee Sznewajs meet with lactation specialist Dawn Reidy to discuss breastfeeding their newborn Leo.

The report titled, “One Hospital at a Time: Overcoming Barriers to Breastfeeding,” ranks UCSF number four out of hospitals throughout California based on their rates of exclusive breastfeeding, 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 breastfeeding mothers to give children the best chance at good health from birth.  

“The health benefits of breastfeeding are above and beyond anything else,” said Dawn Reidy, RN, who is certified by the International Board of Lactation Consultant Examiners (IBCLC) and 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 Carol Miller, MD, 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 breastfeeding assistance and all new nurses spend a day following a lactation specialist, a certification that requires more than 1,000 hours working with individual breastfeeding moms and babies. Residents in obstetrics and pediatrics must attend a lecture on breastfeeding and the intensive care nursery is staffed with its own lactation consultant.

Benefits of Breastfeeding

That education is then 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 and 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 breastfeeding support.

Breastfeeding 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. The American Academy of Pediatrics recommends that women who do not have health problems exclusively breastfeed for the first six months of life to give maximum benefits to the baby.

“Breastfeeding 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, PhD, 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.”

Photos by Cindy Chew

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