New habits; achieving Baby-Friendly status through Best Fed Beginnings project

A while back I read this really cool New York Times article about creating new habits.

Author Janet Rae-Dupree writes, “…brain researchers have discovered that when we consciously develop new habits, we create parallel synaptic paths, and even entirely new brain cells, that can jump our trains of thought onto new, innovative tracks.”

Because habits often carry negative connotations, like fingernail biting, junk food eating and arriving late, this is such a revolutionary way to think about routine.

Rae-Dupree continues, “the more new things we try — the more we step outside our comfort zone — the more inherently creative we become, both in the workplace and in our personal lives.”

New habits may have proven positive results, but the process of creating them isn’t always so easy.

The National Initiative for Children’s Healthcare Quality (NICHQ) recently released Working Toward Baby-Friendly: Improving Breastfeeding Support in US Hospitals, a video that follows the stories of four hospitals work to achieve Baby-Friendly status through NICHQ’s Best Fed Beginnings quality improvement project.

Find the video below at or


The Best Fed Beginnings project launched in June 2012. NICHQ recruited 89 hospitals through an application process to participate in a 22 month learning collaborative to improve breastfeeding support in U.S. hospitals through Baby-Friendly designation.

The video highlights hospitals working through the challenges of creating new habits-system-level changes to maternity care practices.

For instance, Missouri’s Barnes-Jewish Hospital strives for more patient-centered care in a large facility, New Mexico’s Presbyterian Hospital works to increase skin-to-skin contact even after c-sections, Delaware’s Christiana Hospital focuses on staff buy-in and the University of Alabama at Birmingham Hospital engages its community by changing misconceptions about breastfeeding. [Retrieved from:]

(NICHQ makes sure to disclaim that because the hospitals were filmed during the process of becoming Baby-Friendly, some of the video’s images do not represent Baby-Friendly standards.)

Although creating change is difficult at times, staff members report excitement about their involvement in the project. They also report extremely positive patient satisfaction.

“We hope it will inspire and motivate other hospitals to take on this work,” NICHQ’s Senior Director of Marketing and Communications Jonathan Small says of the video.

Best Fed Beginnings emphasizes a collaborative approach that staff members also appreciate.

Small calls it all teach, all learn.

“This is hard work and it’s good to know you are not alone,” he says.  “…Everyone can learn from the successes and failures of all participants.  This accelerates the learning exponentially.”

Because a major concern of hospitals working toward Baby-Friendly designation is staff training, NICHQ offers many options which include:

  • working with staff lactation specialists to conduct the training

  • working with local/state public health departments that offer lactation courses

  • and offering CE credits or the equivalent for physicians to get the required hours of training.

Participating staff members also express concern about disinterested employees. Small says that this is where leadership comes in.

“All affected staff members need to understand the reason for the change and why it’s ultimately beneficial to the patient,” he says.  “It’s about everyone having a shared vision.  Change is hard, but it becomes much easier when there’s a clear benefit to the patient.”

In fact, Small says that NICHQ has pioneered this idea of engaging patients and families on the collaborative team.

“Their first-hand experiences and unique perspectives completely change the conversations on these teams and their contributions to improvement work are invaluable,” he explains. For more information about this approach visit:

Through the course of the project, participating hospitals collect process and outcome measures.  Process measures track the implementation of the steps involved (such as the percent of infants rooming in or the percent of mothers given formula samples).  Outcome measures follow the success of the ultimate goals (such as the percent of infants fed only breast milk), Small explains.

While the collaborative is scheduled to conclude in March 2014, Small says there will be an effort to continue the program.

“The general approach is that the “graduates” of a learning collaborative become expert resources and sometimes faculty for subsequent efforts,” he says. “So their experience becomes expertise for spreading the lessons learned.”

For more information about Best Fed Beginnings, please visit:

To learn more about the Baby Friendly Hospital Initiative, visit:

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