“I would say there’s a total commitment from the team on the unit for breastfeeding. They all have a passion for breastfeeding.”
That’s how Wendi Thomas, RN, MSN, Director of Nursing at Petaluma Valley Hospital, Providence in Petaluma, California, explains the hospital’s impressive exclusive breastfeeding rates.
In 2021, the hospital achieved a 100% exclusive breastfeeding rate among its discharged mothers in 7 out of 12 months. It’s average exclusive breastfeeding rate for the year was 97% (299 out of 307 patients audited).
These remarkable results can be explained in part by the fact that California residents are more prone to breastfeed than those in most other states, and by the hospital’s small size (343 total births in 2021) which allows for a high level of personalized care for most mothers. Yet, there are other contributing factors at work to account for these outcomes.
The first factor is an aligned, collaborative partnership with the providers at Petaluma Health Center, a federally qualified health center clinic about 2 miles from the hospital.
“About 80% of our patients come from the health center,” says Lisa Portman-Fain, RNC, IBCLC, the hospital’s Baby-Friendly lead. “The moms are consistently hearing the message that breast milk provides the optimal nutrition for the baby. It’s really rare that we have a mom walk in saying, ‘I’m going to formula feed. I’ve already made my decision.’”
“We are so closely connected and complement each other so well,” she says. “We know that what they’re telling their patients in the prenatal period is aligned with what we’re telling them when they come to the hospital.”
Once in the hospital, patients will notice the hospital’s overarching commitment to breastfeeding. Sixty-two percent of the staff in the Family Birthing Center are either certified as IBCLC or are certified in some other way for breastfeeding, according to Thomas.
Left to right: Rebecca Lopez, Kay Naragon, Ann Baldwin, Wendi Thomas, Lisa Portman-Fain, Evelyn Castro
“A lot of our moms say they had a hard time with their last child and really want to make it work this time,” says Portman-Fain. “We can say, ‘We have several lactation consultants who are ready to help you and the nurses are all highly trained in breastfeeding.’ Everybody really likes that.”
The hospital also has an active Breastfeeding Committee which reviews policies and results every month and sets the course for quality improvement initiatives.
One of these initiatives is the post-discharge phone call.
“At a minimum, we place one post-discharge phone call specific to breastfeeding with every mom who delivers at the hospital,” explains Thomas. “We ensure they have the resources they need for ongoing breastfeeding support, and that we are available 24/7 if they’re having trouble with breastfeeding.”
All of this is part of what Thomas says is a broader commitment to the system-wide Providence Promise: “Know me, care for me, ease my way.”
“For us, Baby-Friendly embodies all of those things, particularly the phrase about easing my way,’” she says. “It is common for moms to have fears or even some ambivalence about breastfeeding. It takes time to get acclimated, but we have a commitment to easing their way, helping them to experience the process and understanding its benefits for them and for their baby.”
A Perfect Fit
Petaluma Valley Hospital, Providence was initially designated Baby-Friendly in 2015 and recently was re-designated for another five years in 2020. They are the only hospital in Sonoma County that has this designation.
Both women say the designation and re-designation processes were relatively painless for their facility and found value in the process.
“The path to becoming Baby-Friendly wasn’t a giant leap for us, because it aligns with the work we were already doing,” says Portman-Fain. “When we looked at the requirements for designation, providers and nurses all said, ‘Yeah this will work for us.’ And we wanted to do it so we could provide the best for the newborns in our care.”
“The Baby-Friendly designation is a perfect fit for our hospital,” adds Thomas. “Our philosophy around breastfeeding mirrors that of Baby-Friendly. We hold ourselves to a high standard here. We want to make sure that we verify that our processes are aligned with the most effective recommendations currently available, validating the way we should be approaching this process.
“When no one’s watching, it’s easy to slip back,” she continues. “The certification process keeps us on our toes.”
If the hospital’s exclusive breastfeeding rates are any indication, their commitment is truly paying off.