Health

Breast is Best at Indian Health Service hospitals

By Bill Graves / Native Health News Alliance

Not so long ago, when a mother delivered her baby at Claremore Indian Hospital in Oklahoma, nurses would whisk the newborn away to be weighed, shot with vitamins, placed in a warmer and wrapped in a blanket. Only then would a nurse place the wrapped-up infant in the mother’s arms.

But after decades, this routine has changed.

Today, every newborn, even those delivered by Caesarean section, is immediately placed onto the mother’s bare abdomen.

“Skin to skin is the foundation for successful breastfeeding,” says Jenna Meyer, a nurse and former coordinator of the Baby-Friendly Hospital Initiative to promote breastfeeding at Claremore. “Babies will travel to the breast and latch on without much assistance. It helps establish breastfeeding early on and helps sustain breastfeeding.”

Indian Health Service Director Yvette Roubideaux two years ago launched the IHS Baby-Friendly Hospital Initiative in conjunction with First Lady Michelle Obama’s “Let’s Move’ in Indian Country” campaign dedicated to reducing childhood obesity.

The goal is to see all IHS hospitals certified by Baby-Friendly USA, Inc., a program administered through the World Health Organization and the United Nations International Children’s initiative. To be certified, hospitals must successfully put in place the initiative’s Ten Steps to Successful Breastfeeding.

Becoming Baby-Friendly

Some IHS hospitals already are becoming Baby-Friendly certified:

·      This summer, the Claremore Indian Hospital in Oklahoma and the Phoenix Indian Medical Center in Arizona won Baby-Friendly certification.
·      Last year, the Quentin N. Burdick Memorial Health Care Facility in North Dakota and the Pine Ridge Hospital and Rosebud Indian Hospital in South Dakota received their certifications.
·      IHS has set a goal of seeing all 13 of its hospitals with obstetric facilities Baby-Friendly certified by the end of 2014, says Tina Tah, who works in Rockville, Md., as senior nurse consultant in the IHS public health nursing program. 

IHS aims “to increase breastfeeding rates to promote a healthy start in life and to prevent obesity,” she says.

Studies show breastfeeding improves brain development in infants and reduces a variety of health problems ranging from Sudden Infant Death Syndrome to respiratory illnesses, allergies, tooth decay and ear infections. The initiative encourages mothers to exclusively breastfeed their babies for six months. IHS also is urging tribal hospitals and clinics to adopt Baby-Friendly practices, says Tah.

Baby-Friendly steps

Implementing all 10 Baby-Friendlysteps typically takes several years, but some IHS hospitals are moving faster. Claremore won certification in June, less than two years after it launched an intensive training program for doctors, nurses and staff. The challenge was to overcome practices entrenched for decades, Meyer says.

“Nurses would give the baby some formula because they thought it was the right thing to do,” she says.

Some of the 10 steps call for the hospital to:

·      Provide mothers no artificial nipples or pacifiers and infants no supplements unless medically indicated.
·      Inform all pregnant women about breastfeeding benefits
·      Helps mothers initiate breastfeeding within half an hour of delivery
·      Practice rooming-in so babies stay with their mothers 24 hours a day
·      Encourage breastfeeding on demand
·      Foster breastfeeding support groups for moms after they leave the hospital.

Once Claremore started putting these practices into place, change took on a life of its own, says Meyer.

“Moms weren’t having as much trouble breastfeeding because they were getting off to such a good start,” she says. “Everybody got excited.”

Rosebud Indian Hospital

Rosebud Indian Hospitalin South Dakota, the first IHS hospital to earn Baby-Friendly certification in September of 2012, saw a similar transformation, says Clifton J. Kenon Jr., IHS maternal and child health consultant for the Aberdeen area.

The hospital launched an intense training program that included 30 hours of education for nurses and five-to-10 hours for every doctor and provider. The staff learned the value of skin-to-skin, how to manage breast engorgement and a host of other practices to support breastfeeding as the new norm, Kenon says.

Pregnant women who said they were not going to breastfeed changed their minds after experiencing skin-to-skin, Kenon says.

Moms got their first education on the benefits of breastfeeding the moment their pregnancy test showed positive, and they got more instruction with every prenatal visit, up to 15 sessions, Kenon says.

Neither the IHS nor the hospitals supplied hard numbers on the results of their shift to Baby-Friendly practices, but they say they are seeing a surge in the share of mothers breastfeeding. Rosebud is now seeing 90-to-100 percent of its mothers initiate breastfeeding after birth, Kenon says.

Claremore similarly saw breastfeeding initiation rates climb and formula supplementation rates dramatically decrease, says Meyer, who recently joined the Hopi Health Care Center in Arizona.

“The moms are having an easier time breastfeeding, and I see increased confidence in themselves,” she says. “I’m pretty confident we are making a difference.”