EP1EO-2 CENTURA LACTATION CONSULTANTS MINUTES September 13, 2010 (Yellow highlight is PSFHS-SFMC RN’s)

Present: Maria Telfer, Peggy Massie, Camille Patton, Amy Furfari, Denise Davidson, Brenda Schmidt, Lorry Watkins, Mary Jo Foley,and Jolene Bedford
Centura Breastfeeding Policy and policy re breastfeeding preterm infants / Decided it would be difficult to develop a whole BF policy acceptable to all facilities.
Best to work on small parts.
One topic most needed is BF and Preterm infant. / Decided to review AABFM Protocol # 10, Parker’s policy and Avista’s policy – we all received at previous meeting
Next meeting:
  • Bring a copy of your policy format
  • Be prepared to contribute to development of Centura wide policy for those of us that don’t have one. Half of our meeting will be devoted to this project.

Equipment / No report on use of Premie Plus cards, no one has them except Parker.
Medela Milk Warmer trial done at SFMC, but did not go well.
Children’s uses Penguin brand warmers. / Conclusion that most NICU’s have not yet recognized importance of consistent warming methods and temps for infant milk.

Mercy Hospital Durango

/ Jolene did contact Jennifer Hyson in Durango. And informed her of the Centura Lactaion Team and its activities. Copies of our purpose, minutes, ban the bag letter etc were sent. Durango is not yet on Centura E-mail. / They will investigate their ability to participate.
Ban the bags / Facility reports:SAC, SAN and Summit had already stopped giving bags.Summit reports their OB’s no longer give out formula bags.St. Mary Corwin and St. Thomas Moore are making progress. They are looking into what competitors do and are beginning to talk to Peds. There have been many administrative changes this summer also, making it difficult to bring the topic to administration attention. Maria will talk to Geri Davis to see if Parkview is going to ban bags as well. / Will follow up at next meeting with Littleton, Avista, Parker, St. Thomas Moore and St. Mary Corwin.
.
Facility Reports / SFMC – recently did a chart review to identify how many breast babies receive formula. NICU and babies with legit medical reasons were not included in the final group studied.
Results – 45% of our breastfeeding babies are getting formula!
Actions Planned
  • Ban the bags
  • chart review results to staff
  • staff education re reasons formula should not be used
  • new staff requirement to chart the reason formula was given on the Newborn Flow Sheet in Meditech
  • develop teaching sheet to give mothers and as guide for staff to discuss use of formula with BF mothers.
  • Next chart reviews
Discussion : Should parent have to sign a consent to give formula to baby after receiving education? Should a Dr order be required? Could mom just sign teaching sheet she was educated??
St. Anthony Central – all RN’s need to be certified in area of work. They are using the University of Virginia on- line 2 hour education program to educate staff on breastfeeding basics, it is updated frequently
Also, upon move to New St. Anthony hospital in Sept 2011, they will have all Colorado Can Do 5 in place, their intent is to get BF Friendly status.
St. A North – discussion of staffing difficulties in small hospitals where there is only one LC - too much to do. Summit – report that this group was helpful when policies had to be written quickly to prepare for JCAHO. They have teamed with WIC to get Spanish educational materials.ALL- discussion of pump kit recall; discussion of frustration with sweeties being used to entice babies to breast. All agree this should be discouraged. / SFMC teaching sheet shared with group, it is still a draft and may have some changes based on staff input.
Lorry will forward the web address to us all to view this resource.

To Senior Leadership – CEO, CMO and CNO’s September 2010

The Lactation departments in Centura hospitals are committed to supporting Centura Health’s 2020 plan for creating a stronger and healthier tomorrow in our communities. In June 2009 The United States Breastfeeding Committee reported that “Breastfeeding prevents many costly chronic diseases in mothers and children and acute illnesses in infants. More than $14 billion per year could be saved by strengthening…breastfeeding support. Health Care Reform begins with breastfeeding.”

Centura facilities have established a reputation for excellence in patient care and are front runners in health promotion and health education in Colorado. One more way that Centura can Move Up Streamto Manage Health is to have strong lactation departments and breastfeeding support for mothers and babies. The lactation services our facilities provide are an important first step in preventing disease and lowering the cost of health care for mothers and babies throughout their life time. We provide in-patient care and services to get mother’s and babies off to a good start and out-patient services to help ensure breastfeeding is successful and breastfeeding duration is extended as long as possible. However, there is an opportunity for improvement we would like to share with you.

As a group, the Lactation Consultants of all Centura facilities would like to ask Senior Leadership to help us send a clear health promotion message to our patients in support of breastfeeding by eliminating the practice of distributing free formula products and promotional items in all our hospitals. Formula companies have traditionally provided thousands of dollars worth of formula at no charge to hospital nurseries and then expect that their gift bags will be distributed to all discharged mothers. Formula gift bags handed out at discharge serve to advertise a commercial product to gain market share for individual companies. We believe this is an integrity issue. Most importantly, research has shown that receiving a formula gift bag is detrimental to the success of breastfeeding.

The World Health Organization, The Academy of Breastfeeding Medicine, The American Academy of Pediatrics, The United States Breastfeeding Committee and The Department of Health and Human Services are only a few of the organizations that strongly support exclusive breastfeeding and are asking hospitals to stop the practice of distributing free formula and promotional items for formula companies. Even the Joint Commission has included exclusive breastfeeding in the new Perinatal Core Measures for 2010. The AmericanAcademy of Pediatrics wrote in “Breastfeeding and the Use of Human Milk”, that “Obstacles to initiation and continuation of breastfeeding include……commercial promotion of infant formula through distribution of hospital discharge packs.” The following Colorado hospitals have already eliminated formula gift bags: Children’s Hospital, Good Samaritan, Boulder Community, PoudreValley, Denver Health, VailMedicalCenter, St. Joseph’s and each of the three St.AnthonyHospitals (Central, North and Summit). We feel that ALL Centura Health hospitals should follow suit.

We know there may be some barriers to implementing this suggestion but we are committed to sharing possible solutions we have identified and doing our part to facilitate change. We appreciate your serious consideration of this request and we thank you in advance for your timely attention to this most important matter. Please do not hesitate to contact your specific Lactation department for questions. The Centura Lactation Team will meet again in September 2010 and we hope to discuss your response at that time.

Respectfully, Nicola Harden-Ben; Jill Hon; Mary Jo Foley; Camille Renier; Lorry Watkins; Jeannine Hoelsken; Teresa Sanderlin; Mary King; Kelly Allison-Pickering; Diane Eitel; Marylynn McCullough; Clair Hendrickson; Christina Enloe; Susanna Henney; Jolene Bedford; Amy Furfari; Denise Davidson; Brenda Schmidt; Susan Wilczynski; Maria Telfer and Peggy Massie. Team Contact Person: Jolene Bedford, SFMC, 719-571-3125