Although the majority of new mothers in Texas breast-feed after delivery, only a small percentage continue to exclusively breast-feed their babies at six months, despite the many benefits. The Texas Ten Step Star Achiever Breastfeeding Learning Collaborative aims to boost that rate by helping hospitals create environments in which a woman’s choice to breast-feed is supported and encouraged. Methodist Charlton Medical Center in Dallas and Methodist Mansfield (Texas) Medical Center are among the first 20 hospitals selected to join the five-year quality improvement project.

"We want to make sure we are providing the best care for moms and babies, so they are getting off to a great start," Reba Godfrey, RNC-MNN, IBCLC, LCCE, a lactation consultant at Methodist Charlton, said.

Besides being associated with reduced risk of infant mortality and maternal illness and enhancing a baby’s immune system, breast-feeding has many other benefits that can be highlighted to new moms. "There are many reasons why women should continue to breast-feed until six months," Holly Fuller, RN, IBCLC, lactation consultant at Methodist Mansfield, said, explaining that women who breast-feed usually experience a faster return to their pre-pregnancy weight, sleep better, are less depressed and, in the long term, have fewer reproductive organ cancers.

The Centers for Disease Control and Prevention reported that in 2009 80.3% of Texas moms started breast-feeding, but only 13.7% were still breast-feeding exclusively at six months. That compares to 76.9% of moms nationally who tried breast-feeding and 16.3% who were still exclusively breast-feeding at six months. HealthyPeople 2020 has set a target that 25.5% of babies will be exclusively fed breast milk until six months.

Efforts to promote breast-feeding begin before delivery and continue during the hospital stay, said Fuller. Prenatal classes at both hospitals provide information about breast-feeding benefits. Mansfield also offers a breast-feeding class. "We help them formulate a plan to remove barriers to breast-feeding," Fuller said. That may include discussing where new mothers can pump once they return to work and where to store that milk. Texas laws require employers to provide such a place, but sometimes the new mom must initiate the discussion.

Another barrier is if no one in the mother’s family had breast-fed, Vicki Wiseman, RN, RNC-OB, director of women’s services at Methodist Mansfield, said. "Our job in that case is to educate and provide resources and help the mother identify a support person," Wiseman said.

Immediately after delivery, nurses place the newborn with mom, initiating skin-to-skin contact that helps stabilize the baby’s body temperature and readies the mother’s body for breast-feeding.

Both facilities are committed to furthering training to 20 hours for nurses to provide optimal lactation support and nutritional and developmental outcomes for newborn babies and their mothers. "Our nurses do an excellent job of helping moms trying to breast-feed but a little more education is always helpful," Godfrey said.

Additionally, nurses round with a lactation consultant. Moms can contact the lactation consultant for free advice after discharge.

Learning collaborative participating hospitals will share information about their programs’ successes. The National Initiative for Children’s Healthcare Quality is leading the Texas Breast-feeding Learning Collaborative, which is funded by the Texas Department of State Health Services and the Texas Special Supplemental Nutrition Program for Women, Infants and Children. Eighty additional hospitals are scheduled to be added during the next two years.