Christa Rudat, Key Driver of North Baldwin Infirmary’s Baby-Friendly Success, Joins BFUSA

Christa Rudat, MSN, RN, IBCLC was ready. She had been at North Baldwin Infirmary in Bay Minette, Alabama, for less than a year when Gena Cash, the Manager of the Birth Center, came to her to ask for her help in pursuing Baby-Friendly designation. Christa was all in.

“I had an eight week old baby at home when I interviewed for this job,” Christa recalls. “I had a lactation mindset and a personal love for breastfeeding. So, I was kind of her subject matter expert, and we worked together to build it up and get the ball rolling.”

That mindset had already led her to question much of what she saw happening in the Birth Center.

“When I started here, they didn’t have any lactation support and we were routinely separating moms and babies,” she remembers. “I would see a staff member feeding a baby a bottle in the nursery and I would ask if the mom was formula feeding. And they’d say, ‘I don’t know, but the baby is hungry, so I’m feeding her.’”

“There wasn’t really anyone protecting breastfeeding at that time,” she says.

But all that began to change when Gena and Christa teamed up to tackle the Baby-Friendly pathway.

Total Culture Change

North Baldwin Infirmary is a small facility in rural Alabama, about a half hour northeast of Mobile. Resources are not abundant, and people tend to be set in their ways. Gena and Christa knew that committing to Baby-Friendly practice would require a significant culture change for the facility and the community.

“Thankfully, we had buy-in from our CNO and our administrator at the time,” says Gena. “They had our backs and were always supportive of us — as long as we were doing evidence-based care and what was best for our patients.”

“We had some very opinionated providers, so we had to work some things through with them,” recalls Christa. “It really is total culture change.””

One resistant doctor, for example, insisted on weighing the baby for the medical record before letting the mom and baby go skin-to-skin. So, the team found a way to gradually bring this doctor along.

“We would push the scale right up to the mom’s bottom, so when the baby came out, the doctor would quickly drop the baby on the scale and then go right to skin-to-skin. But we slowly graduated them away from that approach,” Gena laughs.

Their efforts eventually paid off when North Baldwin was designated Baby-Friendly in 2017. The facility was re-designated in 2023.

So Different Now

“It was a big change,” remembers Christa. “But the staff learned a lot, and once they saw it in action, they said they couldn’t believe we hadn’t been doing it this way all along.”

The staff members were most convinced when they saw the impact Baby-Friendly practices were having on moms.

“Seeing them hold their baby skin-to-skin after delivery, and then having the baby in the room with them the entire stay, learning how to respond to the baby, it’s really an awesome thing to see,” says Christa. “Our moms feel more empowered and more confident because we give them the tools and support they need.”

It’s hard to even picture what life was like before,” says Gena. “Everything is just so different now.”

Equitable Care

Christa believes one of the most important things that are different is the fact that Baby-Friendly  ensures equitable care for all patients by creating uniformity in the information and support families receive. This is critical at North Baldwin where the majority of mothers are women of color.

“Baby-Friendly ensures we give the same education to all patients, no matter what,” says Christa. “It neutralizes the biases that people have.”

Research has shown that, in the absence of consistent standards and policies, healthcare providers often guess at who they think is most likely to breastfeed and direct their care and energy there. Women of color are frequently assumed to be unlikely to breastfeed because of historical trends, and this leads to a self-perpetuating cycle of disparate care leading to disparate breastfeeding outcomes.

“We’ve learned that we can make a difference and sometimes it’s us, not the patient,” Christa reflects. “Patients sometimes do what we expect of them. And if what we expect of them is different, based on their race or their income or something like that, then they’re going to react accordingly. If we go in and just provide non-biased education, then we are really elevating the experience and helping patients that may not have felt as empowered previously.”

Keeps Us From Slipping Back

All of the changes they’ve made have led to increased rates of exclusive breastfeeding over the past few years – from a baseline of 12% in 2014 to around 40% today.

And it even led to some nice coverage on the local news featuring Christa and her colleague, McKenzie Benton, LPN, whom Christa has trained to take over her Baby-Friendly leadership role at North Baldwin.

But Christa has taught everyone not to rest on their laurels.

“When we finally got designated, people said ‘Okay, we don’t need to talk about Baby-Friendly for a while,’” she recalls. “But I said, ‘No, we have to keep it going because we have an annual quality improvement assessment coming up with BFUSA. That keeps us from slipping back into old mindsets and old habits.”

Next Adventure

Now Christa is ready again – this time, to take on a new job as a Clinical Review Specialist for BFUSA. It’s an ironic but logical next step in her career.

“I have been the person who sends in the paperwork to the Clinical Review Specialist at BFUSA,” she says. “Now I will see it on the other side – and I’ll be the one assisting hospitals and giving them feedback and letting them know what they’re doing well and what they need to work on to meet BFUSA’s Guidelines and Evaluation Criteria.”

Gena will miss Christa for sure. But she’s grateful for her leadership that put them on this path and for her commitment to spreading her values and knowledge among the rest of the staff.

“We couldn’t have done it without her,” Gena says. “It was a team effort and it took every single one of us, but Christa definitely led the way and kept us up on track. Whenever we let our guard down a little bit, she’d remind us that we have to learn to do this every day and live it every day.”

“She’s just one of those people who will always have a special place in your heart.”