Katz Women’s Hospital at NSUH Achieves Large-Scale Change En Route to Baby-Friendly Designation

After Marianne McTyre and Rachel Cascone, leaders of the Baby-Friendly effort at Katz Women’s Hospital at North Shore University Hospital (NSUH), met with their BFUSA surveyors at the end of their assessment visit in April 2025, there wasn’t a dry eye in the house.

“We all started crying,” recalls Rachel (pictured, front row), a Clinical Program Manager at Katz. “It was such an emotional experience to spend three years really focused and then have it all come together on these two days. It was absolutely incredible.”

Soon after that, Katz at NSUH received the official word they had been designated as Baby-Friendly.

“I still get chills thinking about it,” says Rachel.

Upon designation, BFUSA noted this facility exemplified excellence in embracing the Baby-Friendly principles and embedding them into their culture of care. The core team showed an above average attention to detail and exceeded expectations through innovation, collaboration, and an unwavering commitment to quality care.

Sheer Magnitude

What makes the story of Katz at NSUH’s Baby-Friendly journey so notable is the sheer magnitude of the changes required to achieve the designation. Located on Long Island, New York in Manhasset, Katz at NSUH is part of the Northwell Health system. With an average of 6,000 births per year, Katz at NSUH is among the highest volume Labor and Delivery units in the state.

Their journey to Baby-Friendly began in 2021 when Marianne (pictured, back row in pink), the Director of Patient Care for the Hospital, who was at the time new to the mother-baby service line, decided it was the right thing to do.

“I began to hear about Baby-Friendly and wondered what it was about,” remembers Marianne. “I knew that our colleagues at Long Island Jewish had achieved designation and I thought, ‘Wow, this is something I’d really like to accomplish for this service line.’ So, we gained the support of senior leadership, established a strong physician partnership, and began our journey.”

They joined the EMPower Breastfeeding Initiative, a hospital-based quality improvement project funded by the CDC and led by Abt Associates in partnership with Carolina Global Breastfeeding Institute (CGBI) and Population Health Improvement Partners. That initiative helped frame the tools and process for educating and training their staff of 300+ nurses and 100+ physicians.

“We used a train-the-trainer model,” recalls Rachel, who presented a poster outlining the highly successful, complex process at the 2024 AWHONN conference. They trained two RN trainers per unit and shift, 52 trainers to start. EMPower helped them design six skills stations, one of which was included each month in a monthly skills fair. The trainers were trained first and then the effort spread to the other staff members. They also created videos, digital slides, and printouts containing all the knowledge needed to demonstrate skills competency.

“People could complete pre-work asynchronously on their shift whenever they wanted and they could go to anyone who was a trainer on their unit when they were ready to complete the demonstration of their skills,” explains Rachel. “That asynchronous pre-work really cut down the time for us in terms of getting everyone prepared for each station. They were able to do it all at work, which is pretty significant when you have this many people.”

Teamwork and Leadership

Katz’s Baby-Friendly journey is also a story of teamwork and leadership.

“The level of teamwork that we had here — from nursing leadership to nursing staff to physician support, labor and delivery, postpartum, and high-risk NICU — was incredible. It was unbelievable how many people needed to be involved,” says Rachel. “It also impacted so many of our other departments — Transport and Dietary, for example.”

A key driver was a standing Baby-Friendly meeting that Rachel convened every week for three years.

“Every Tuesday, at 12 o’clock, we got together and said, ‘What have we accomplished? What do we need to work on? What’s our focus now?’” says Rachel. “We always left that meeting with clear next steps. It made everybody accountable, helped us stay on track, and gave everyone a sense of excitement that we’re all in this together.”

“Rachel deserves a great deal of credit for leading this massive effort,” says Marianne. “She drove this thing from beginning to end, talked about it continuously, and was always asking ‘What can we do?’ Truthfully, it came down to having a lot of resilience and supporting each other, because there were a lot of ups and downs.”

Culture Shift

Aside from staff training, the biggest change the team experienced was a cultural shift related to rooming-in practices.

“For me, the biggest transformation was that our model of care previously promoted us taking care of the mom really well and taking care of the baby really well, but not necessarily together,” says Marianne. “We had three nurseries that were filled almost all the time with babies not being in the rooms with their mothers. Everybody in the hospital needed to look at it as one unit, the family, and do whatever we can to support that bonding, to support their choice of feeding and not have separation.”

The staff reflect this culture change in their motto, “non-separation is the best preparation.” That attitude is palpable to patients.

“I reflect sometimes back on what my experience was 30 years ago when I gave birth to my daughter here, as compared to today,” says Marianne. “I don’t remember even really seeing my baby. She stayed in the nursery. She was fed a bottle. There was no question about breastfeeding. And two or three days later, I was sent home. I don’t even remember being taught anything. I’m not saying anything negative about it; that’s just the way it was. My baby was very well cared for, and I was very well cared for, but we certainly weren’t treated as a couplet.”

Catching Up

Data collected pre- and post-Baby-Friendly implementation bears out the fact that the changes are making a massive difference. The facility’s mPINC score of 47 in 2020 jumped to 88 in 2024, well above the national average.

And they’ve achieved significant reductions in racial and ethnic disparities for skin-to-skin care and breastfeeding initiation during that time as well:

“We needed to catch up in terms of the standard of care,” says Rachel. “The accountability that the Baby-Friendly program and the designation requires and instills made us more consistent in how we implement care across all patients.”

“I just felt incredibly proud of everyone. We all worked so hard, to achieve this,” says Marianne.