Birthways Lactation Services: A Model for Breastfeeding Support
Article first published online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, page S36, June 2012
How to Cite
Carswell, A. (2012), Birthways Lactation Services: A Model for Breastfeeding Support. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S36. doi: 10.1111/j.1552-6909.2012.01360_10.x
- Issue published online: 14 JUN 2012
- Article first published online: 14 JUN 2012
- lactation program;
- exceeding national and state breastfeeding rates
Purpose for the Program
The purpose of the Birthways Lactation Services program is twofold. We want to increase breastfeeding initiation and duration rates and thereby improve long-term health for every infant. We also want to increase the lactation consultant's productivity while decreasing full time equivalents and cost. Most lactation programs have lost state funding in recent years and are now funded by hard-to-find grants, or as in our hospital's case, by community benefit dollars.
For 10 years, our program was set up to provide home visits to our clients (within a 50 mile radius) who either chose to have a visit or when a visit was physician ordered. Eight years ago, it was determined this was a costly way to deliver care even with funds provided by a grant and some insurance reimbursement. At that time we started the clinic model and were encouraged by the positive results. Our lactation consultants cross-train to the discharge planning position of the Birthways Lactation Services program where they round with the pediatricians, schedule the clinic visits at discharge, and provide a discharge feeding plan for babies with feeding problems.
Implementation, Outcomes, and Evaluation
Three to five times per day, the coordinator of the lactation program and her team perform checks that include weight, jaundice, and lactation evaluation. We believe our outcomes reflect the success of the program. Our breastfeeding initiation rate is 87.6% as compared with the state's 73.9%. Our 6-month breastfeeding rate is 79.3% (one of the best in the state) as compared with the national rate of 17%. We are ahead of the Healthy People 2020 goals of an 81.9% initiation of breastfeeding and a 6-month breastfeeding duration of 60.6%. Our home visit model took 3.1 full time equivalents, and our clinic model takes 1.2 full time equivalents, which represents a savings of more than $140,000 in salaries and mileage reimbursement. Our lactation consultants can see five more infants per day or 25 more per week, which makes it possible to provide second visits for those clients who need them.
Implications for Nursing Practice
The advantages of breastfeeding are well researched and well documented. We believe our program model is the best practice and is leading the way in breastfeeding promotion and support of the American Academy of Pediatrics Policy Statement and the U.S. Surgeon General's Call to Action to Support Breastfeeding. Our service model decreases hospital readmission rates and promotes exclusive breastfeeding with increased productivity and decreased cost.