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• W2731234879 abstract "Children's first food lays the foundation for health, growth, and development. Exclusive breastfeeding (BF) provides the nourishment, hydration, and immunological protection for optimal growth and development in the first 6 months of life1Victora C.G. Bahl R. Barros A.J.D. et al.Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.Lancet. 2016; 387: 475-490Abstract Full Text Full Text PDF PubMed Scopus (3335) Google Scholar and can also be empowering for women2Dykes F. Flacking R. Encouraging breastfeeding: a relational perspective.Early Hum Dev. 2010; 86: 733-736Crossref PubMed Scopus (52) Google Scholar while reducing their risk of a variety of morbidities.3Bartick M.C. Schwarz E.B. Green B.D. et al.Suboptimal breastfeeding in the United States: maternal and pediatric health outcomes and costs.Matern Child Nutr. 2017; 13: e12366Crossref Scopus (207) Google Scholar Leading health organizations recommend that infants exclusively breastfeed for 6 months and continue to breastfeed through at least 12–24 months.4World Health Organization. Nutrition: exclusive breastfeeding. http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/. Accessed December 16, 2016.Google Scholar, 5American Academy of Pediatrics Breastfeeding and the use of human milk.Pediatrics. 2012; 129: e827-e841Crossref PubMed Scopus (3444) Google Scholar However, current rates of BF in the US are far below recommended levels; only 22.3% of infants are exclusively breastfed at 6 months and only 30.7% still receive mothers' milk at age 1 year.6Center for Disease Control and Prevention. Department of Health and Human Services. Breastfeeding Report Card. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf. Accessed December 16, 2016.Google Scholar Furthermore, significant BF disparities persist with Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)-eligible populations compared with women with greater resources.7Sparks P.J. Racial/ethnic differences in breastfeeding duration among WIC-eligible families.Womens Health Issues. 2011; 21: 374-382Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar The Baby-Friendly Hospital Initiative (BFHI) is a global effort to increase BF rates. At the core of BFHI are the Ten Steps to Successful Breastfeeding (10 Steps).8Baby-Friendly USA. Guidelines and Evaluation Criteria for Facilities Seeking Baby-Friendly Designation. http://www.babyfriendlyusa.org/get-started/the-guidelines-evaluation-criteria. Accessed December 16, 2016.Google Scholar As of June 2017, 21.3% of live births in the US took place in facilities that practiced all of the 10 Steps, as measured in the Healthy People 2020 Objectives.6Center for Disease Control and Prevention. Department of Health and Human Services. Breastfeeding Report Card. https://www.cdc.gov/breastfeeding/pdf/2016breastfeedingreportcard.pdf. Accessed December 16, 2016.Google Scholar, 9Baby-Friendly USA. Designated facilities by state. http://www.babyfriendlyusa.org/find-facilities. Accessed June 7, 2017.Google Scholar The US Surgeon General's Call to Action to Support Breastfeeding includes increased uptake of the 10 Steps to promote patient-centered care, to enable more families to realize their infant feeding goals.10US Department of Health and Human Services. The Surgeon General's Call to Action to support breastfeeding. https://www.ncbi.nlm.nih.gov/books/NBK52682/. Accessed December 16, 2017.Google Scholar Step 3 of the 10 Steps requires all pregnant mothers to be educated about the benefits and management of BF. The Ready, Set, BABY (RSB) curriculum satisfies the requirements for Step 3. Ready, Set, BABY facilitates an interactive, conversational approach. Open-ended questions are employed to engage the mother and allow the education to be tailored. This partnership model of communication is recommended by the American College of Obstetrics and Gynecology11Committee on Patient Safety and Quality Improvement. Committee on Health Care for Underserved Women. American College of Obstetricians and Gynecologists. http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Health-Care-for-Underserved-Women/Effective-Patient-Physician-Communication. Accessed December 15, 2016.Google Scholar and provides the critical interpersonal support associated with improved BF rates.12Wouk K. Tully K.P. Labbok M.H. Systematic review of evidence for Baby-Friendly Hospital Initiative Step Three: prenatal breastfeeding education.J Hum Lact. 2017; 33: 50-82Crossref PubMed Scopus (35) Google Scholar Details of the development are available online.13Carolina Global Breastfeeding Institute. Tools for Action—prenatal breastfeeding education. http://breastfeeding.sph.unc.edu/what-we-do/programs-and-initiatives/tools-for-action-prenatal-breastfeeding-education/. Accessed April 30, 2017.Google Scholar This GEM presents the current version of the RSB curriculum and an evaluation, with links to free resources. The RSB curriculum, shown in Figure 1 and Figure 2, is a noncommercial set of BF educational materials intended for use with pregnant women in any trimester. It reflects current recommendations for prenatal education from the BFHI8Baby-Friendly USA. Guidelines and Evaluation Criteria for Facilities Seeking Baby-Friendly Designation. http://www.babyfriendlyusa.org/get-started/the-guidelines-evaluation-criteria. Accessed December 16, 2016.Google Scholar and the Academy of Breastfeeding Medicine14Wood J. Hineman E. Meyers D. Academy of Breastfeeding Medicine Protocol CommitteeClinical protocol number 19: breastfeeding promotion in the prenatal setting.Breastfeed Med. 2009; 4: 43-45Crossref PubMed Scopus (15) Google Scholar and provides additional information pertinent to mothers' maternity care experiences based on literature exploring why US BF women prematurely supplement or wean.15Odom E.C. Li R. Scanlon K.S. Perrine C.G. Grummer-Strawn L. Reasons for earlier than desired cessation of breastfeeding.Pediatrics. 2013; 131: e726-e732Crossref PubMed Scopus (339) Google Scholar, 16Li R. Fein S.B. Chen J. Grummer-Strawn L.M. Why mothers stop breastfeeding: mothers' self-reported reasons for stopping during the first year.Pediatrics. 2008; 122: S69-S76Crossref PubMed Scopus (370) Google Scholar, 17Ahluwalia I.B. Morrow B. Hsia J. Why do women stop breastfeeding? Findings from the Pregnancy Risk Assessment and Monitoring System.Pediatrics. 2005; 116: 1408-1412Crossref PubMed Scopus (226) Google Scholar The curriculum was developed using an iterative process involving input from lactation consultants, BF researchers, maternal and child health students, and health educators between 2011 and 2015. North Carolina WIC was involved after development of the current version. The materials consist of a 28-page color patient booklet with a matching educator flip chart for use by providers or educators in group classes or individual counseling sessions. The flip chart offers open-ended questions and suggested text to facilitate dialogue with mothers and families, or among groups regarding perinatal experiences such as skin-to-skin contact, rooming-in, and BF. The materials were downloaded by >800 unique individuals at the time of publication.Figure 2Example page from Ready, Set, BABY patient booklet.View Large Image Figure ViewerDownload Hi-res image Download (PPT) In a pilot study, 416 mothers from 7 sites were surveyed before and after RSB. Maternal participation significantly improved Infant Feeding Intention Scale scores (P < .001), a known predictor of BF initiation, duration, and exclusivity. Participation in RSB also significantly increased knowledge of 4 recommended maternity care practices (P < .001) (K. C. Parry, MPH, IBCLC; unpublished data; May 4, 2017). Using a protocol intended to obtain subjective feedback about their impression of RSB, improvements suggested, acceptability by patients, etc, educators at each pilot site were interviewed by phone in 2015 by KCP. The interviewees served a variety of populations in settings ranging from a rural community clinic to an urban teaching hospital in the US and Puerto Rico. The educators regarded the RSB visual materials positively, including the layout, images, and graphics. They valued the low-literacy level and third-person vignettes, and the ability to tailor content to address individual patients' needs. Among the comments were: “… It's beautiful, the photographs … and it's simple. I think it's gorgeous. I love how it's laid out.” “… The stories are really helpful because I think the mothers, you know, you have to give clinical information, but you have to make it real. And the way to make it real is to do a story.”“… It's very participant-driven.” To increase maternal participation in what was for most optional BF education outside routine clinical appointments, the educators suggested offering snacks or other incentives for mothers, and referring to RSB as a meeting rather than a class. Other barriers to implementing RSB were the lack of dedicated staff time, funding constraints to printing the free materials, and limited time to add new content within existing appointments. Ready, Set, BABY implementation is feasible in local offices or across health care systems. In North Carolina, the state WIC office offered 4 regional RSB trainings for WIC staff in summer 2016 and made materials available for local WIC agencies to order from the state office at no charge under a US Department of Agriculture grant. Effective prenatal education to satisfy Step 3 and optimally serve families requires collaboration among hospitals, prenatal clinics, health departments, and WIC agencies. Ready, Set, BABY is an easy-to-use, free set of educational materials for counseling prenatal women on BF and interrelated perinatal health processes. WIC offices and educators in other prenatal settings are using these new materials to augment ongoing programs and materials. Along with other resources, RSB may help support women to engage fully in learning about the benefits and management of BF and the importance of exclusive BF. All parts of this study were determined to be exempt by the University of North Carolina at Chapel Hill's Non-Biomedical Institutional Review Board (#14-2271). Ready, Set, BABY is freely available online (http://breastfeeding.sph.unc.edu/prenatal-breastfeeding-education-tools-and-recommendations-for-action-links/) in English or Spanish for downloading, printing, and use. A 2-part online training is also provided, as well as wall posters for waiting areas and an implementation guide to facilitate planning and execution. The development and study of the curriculum is supported by the W.K. Kellogg Foundation. The authors have not stated any conflicts of interest." @default.
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• W2731234879 title "Innovative Prenatal Breastfeeding Education Curriculum: Ready, Set, BABY" @default.
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