Encouraging culture change through the Baby-Friendly Hospital Initiative

Source: United States Breastfeeding Committee.
Source: United States Breastfeeding Committee.

Before birthing and breastfeeding her children, before beginning her career as a lactation professional, Laura Corsig, BA, BS IBCLC, LCCE was captivated by anthropology and women’s studies during her undergraduate program.

The territory felt “deeply innate,” Corsig explains.

Corsig now serves as Novant Health’s (North Carolina) lead lactation consultant where she led a multidisciplinary team to Baby-Friendly designation in 2012.

She will present Perceived Barriers and Facilitators of Healthcare Providers Regarding Implementation of the BFHI at the upcoming International Breastfeeding Conference in Orlando, Fla.

Corsig says that in the beginning of Novant Health’s journey to Baby-Friendly, it “seemed almost impossible without ‘making’ people change.”

“However, in the end, using evidence, influence, and persistence, I didn’t have to ‘make’ anyone change,” she goes on. “It became everyone’s idea in their own time and then we reached a tipping point.  My biggest challenge became my biggest asset.”

Encouragement from hospital administration and other leadership roles made the process surmountable.

“Their support gave me courage to ask questions and challenge old paradigms,” Corsig says.  

Finally, Corsig found comfort in friends she made along the way, like Liz Westwater who currently serves as Healthy Children Project’s newest faculty member.

In light of a recent JAMA editorial that criticizes system-level breastfeeding interventions like BFHI, Corsig says that the author’s comments are not reflective of the Baby-Friendly experience she’s had.

Corsig explains:

We live in a time where complex ideas are whittled down to soundbites and tweets and depth of understanding is lost.  To me, I need to engage both my left and right side brain when reading the BFHI Guidelines and Criteria for Evaluation.  I have learned that I need to read the words and understand the process, goals, percentages of attainment, etc.  That’s my left brain.  I also need to use my right brain to ask myself what is Baby-Friendly’s intent here?  That usually gets me to the crux of the issue.  To me, the article focused on “left brain” standards and ignored “right brain” thinking.  It’s not either/or.  It’s both/and.  Baby-Friendly guidelines are a target to hit and a culture to change. Those have to be attained together and in harmony.  That isn’t easy.  It pushes the healthcare setting to be better.

Over the course of her career, Corsig has welcomed over 10,000 expecting parents in breastfeeding classes.

Source: United States Breastfeeding Committee.
Source: United States Breastfeeding Committee.

“…Teaching breastfeeding class is an honor,” she says. “I feel tremendous responsibility to get breastfeeding class right.”

In a climate where most are asked to do more with fewer resources, teaching a roomful of parents is good time management for lactation professionals, she explains. Group perinatal classes such as the CenteringPregnancy model have also shown improved health outcomes for patients and cost savings for health systems.

Breastfeeding class can also set the tone for what parents might expect with hospital lactation services.

“It’s our opportunity to provide knowledge, confidence and reassurance so they feel in good hands when they arrive and after discharge,” Corsig says. “We want that to be affirming, warm, open, non-judgmental and supportive.”

Corsig considers several factors when coordinating an effective breastfeeding class. For instance, the time classes are offered.

“I am a morning person and I wouldn’t be nearly as good at teaching at the end of a work day,” she explains.

Teaching methods are equally important, especially during Corsig’s classes which total two-and-a-half hours.

“I interject with videos and play music before, after and at break,” she says.  

Corsig envisions teaching her own husband in a breastfeeding class to better reach fathers present.

When constructing breastfeeding classes, it’s important to know that adults learn differently than children; information needs to be relevant.

Linda J. Smith, MPH, FACCE, IBCLC, FILCA offers a wide variety of games and activities for teaching breastfeeding and human lactation in her book Coach’s Notebook: Games and Strategies for Lactation Education.

Corsig has observed that this generation of parents seems to understand preventative health.

“That gives me a lot of hope for our future,” she comments.

Register for the International Breastfeeding Conference here.

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