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Changing the Culture of Maternity Care, in a Hospital and an Island

In 2010 Stony Brook University Hospital (SBUH) joined 11 other hospitals in the New York State Breast Feeding Quality Improvement in Hospital Learning Collaborative to make evidence-based changes in maternity care. The state collaborative included a focus on improving rates for exclusive breastfeeding, an area in which New York lagged. By introducing a new culture of maternity care, SBUH was able to increase its breastfeeding rates and change delivery room behavior, and has been chosen as one of 90 hospitals nationwide to participate in Best Fed Beginnings, a national effort to increase breastfeeding rates.

To reduce separation between mothers and babies after birth, SBUH:

  • introduced the practice of keeping mothers and babies together, skin to skin, immediately after birth, regardless of whether they were breastfeeding.
  • admitted mothers and stable infants directly into the postpartum room together.
  • introduced bedside rounding by pediatric providers.

Best Fed Beginnings

SBUH is continuing its work with Best Fed Beginnings, 22-month learning collaborative designed to make system-level changes to maternity care practices in pursuit of baby-friendly designation, which verifies that a hospital has comprehensively implemented the 10 Steps to Successful Breastfeeding established by the United Nations Children’s Fund and the World Health Organization.

SBUH is the only New York state hospital and one of only two hospitals in the northeastern United States to be chosen for the project.

Through Best Fed Beginnings, SBUH plans to:

  • revisit the practice of keeping the baby with the mother for the initial exam (after the initial skin to skin and breastfeed), which they hadn’t yet sustained at the end of the state collaborative.
  • Move toward a family-centered model of care
  • Recommend that family members, particularly the significant other, stay in the hospital overnight to learn the baby’s cues and use the staff as a resource.

While SBUH has only just begun its work in Best Fed Beginnings, the organization has come miles from where it started with the state collaborative. According to SBUH’s clinical nurse specialist and lactation coordinator, in 2010, Long Island on average had only 5 to 10 percent of mothers exclusively breastfeeding, and SBUH has been able to maintain a rate above 30 percent so far.

For more information about SBUH’s work with the state collaborative and Best Fed Beginnings, please contact:

Kathy Van Deventer, MS, RN, PNP
Clinical Nurse Specialist and Lactation Coordinator
Stony Brook University Hospital
(631) 444-2201

Susan Little, MS, RN, NP
Assistant Director of Nursing for Antepartum, Labor and Delivery, and the Mother-Baby Unit
Stony Brook University Hospital
(631) 444-2155



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