In July 2010, the Connecticut Department of Public Health (DPH) and the Connecticut Breastfeeding Coalition (CBC) collaboratively developed the CBI with funding from Communities Putting Prevention to Work (CPPW), a program of the American Recovery and Reinvestment Act (ARRA) of 2009. The CBI team developed a selection process to enroll ten hospitals in the project. Once the hospitals were selected, the CBI provided the maternity staff at each with training and technical and financial assistance toward achieving Baby-Friendly Hospital designation.
Five of the Ten Steps to Successful Breastfeeding were pre-selected as the focus of the CBI based on: level of importance, need for external assistance, perceived difficulty, likelihood of being achieved within a 2-year timeframe, purposes of project evaluation, and CDC recommendation. Shortly after project implementation began, Baby-Friendly USA, the organization that confers Baby-Friendly designation in the United States, transitioned from a Certificate of Intent process to the 4-D Pathway (Discovery, Development, Dissemination, and Designation). Project activities were adjusted to incorporate these changes.
The goal of the CBI was to provide state-level support for multiple hospitals to achieve Baby-Friendly designation. The CBI hired a consultant with expertise in the Baby-Friendly Hospital Initiative to assist with initiative-level planning, to consult with personnel at participating hospitals and to train maternity care staff.
The CBI’s core activities included:
- Offering each participating hospital up to 40 hours of consultation time,
- Providing the 15-lesson training (as identified by Baby-Friendly USA) for maternity staff and offering guidance to participating hospitals on the five competency hours (clinical experience),
- Recommending appropriate strategies for completing the three Continuing Medical Education (CMEs) hours for MDs,
- Contributing $750 per hospital to disseminate patient and staff education materials,
- Providing financial support for Baby-Friendly USA maternity hospital fees ($4,000 per CBI hospital), and
- Coordinating monthly conference calls and bi-monthly in-person workshops for key hospital contacts for purposes of collaboration and peer support.
Intended population: The CBI’s primary audience is maternity care staff (nurses and lactation consultants); the secondary audience is new/expectant mothers at participating hospitals.
Setting: Hospitals (can also be implemented in free-standing birth centers but was not in this case)
Characteristics of CBI hospitals: Additional characteristics of the hospitals participating in the CBI are provided below:
- Six of the ten participating hospitals were teaching hospitals.
- Each participating hospitals had between 130-896 beds.
- Each participating hospital had a range of 14-112 bassinets.
How long intervention has been in the field: The project period was July 2010 through January 2012. Developers are pursuing sustainability options, but the original funding source, CPPW, is over.