Great Beginnings NY - The Future Starts with Breastfeeding

A hospital-based initiative to support a mother's decision to breastfeed

Background

  • The New York State (NYS) Department of Health recognizes breastfeeding, especially exclusive breastfeeding (exclusivity), as a key public health priority that improves both infant and maternal health and reduces healthcare costs.
  • The Department's goal is to make breastfeeding the norm in NYS.
  • The NYS Prevention Agenda for 2013-2017 focuses on increasing the proportion of NYS babies who are breastfed by increasing exclusivity and improving racial, ethnic and economic disparities in breastfeeding rates.
  • The Centers for Disease Control and Prevention (CDC) prioritizes breastfeeding as a strategy to reduce pediatric obesity by supporting exclusivity and duration of breastfeeding across multiple sectors that influence a mother's decision to breastfeed and/or continue to breastfeed. Multiple sectors include hospitals, pediatric and obstetrical/gynecology practices, child care centers/homes, worksites and others.
  • Hospitals have the unique opportunity to support a women's decision to breastfeed and establish breastfeeding during that critical period right after birth.
  • The American Academy of Pediatrics (AAP), CDC, and World Health Organization (WHO) recommend exclusive breastfeeding for the first six months, with continued breastfeeding as long as mutually desired by mother and infant.
  • New York State Department of Health regulations (10 NYCRR § 405.21) require hospitals to have written policies and procedures in place that ensure breastfed infants only receive supplemental feedings (e.g., infant formula) if indicated due to medical conditions of the newborn or the mother.
  • The regulations also restrict hospitals from distributing discharge packs containing infant formula unless there is a specific order by the attending practitioner or a direct request from the mother.
  • Unnecessary supplemental formula feedings and the distribution of infant formula at hospital discharge can deter exclusive breastfeeding by new mothers.
  • According to the 2011 Surgeon General's Call to Action to Support Breastfeeding, hospital staff should not advertise infant formula and distribute materials such as free samples, pamphlets, notepads, growth charts, or gifts that bear logos from companies marketing infant formula.
  • Infant formula promotion interferes with breastfeeding.
    • Displays of posters, products or decorations in patient areas or the distribution of promotional items from infant formula companies leave the impression that hospitals favor formula feeding over breastfeeding.
    • Formula marketing reassures the public that infant formula is the safe, acceptable norm.
    • Mothers are unable to fulfill their intentions to breastfeed when the newborn receives unnecessary supplementation which interferes with on-demand feeding and the stimulation of the mother's milk supply.

Great Beginnings NY

  • The Department announced the initiative, Great Beginnings NY, The Future Starts with Breastfeeding, to ensure that mothers are better supported in meeting their breastfeeding goals.
  • Health Commissioner Nirav R. Shah, MD, MPH, called on hospital leaders to participate in this initiative by ensuring that four evidence-based strategies are implemented at hospitals providing maternity care services.
    1. Ensure breastfeeding infants do not receive supplementation (infant formula, water, glucose water), unless medically indicated or at the request of the mother and documented in the infant's medical chart;
    2. Educate mothers on the impact of non-medically indicated supplementation on breastfeeding success;
    3. Discontinue the distribution of free infant formula, including discharge packs, and the provision of infant formula promotional materials in any hospital location and as part of patient education; and
    4. Provide all breastfeeding mothers with post-discharge lactation support and referrals.
  • This initiative is aimed at increasing exclusive breastfeeding and restricting the distribution and promotion of infant formula in hospitals providing maternity care services.
  • Great Beginnings NY has been formally endorsed by:
    • The Greater New York Hospital Association
    • The Healthcare Association of New York State, Inc.
    • The Iroquois Healthcare Alliance
    • The Medical Society of the State of New York
    • The New York State Association of County Health Officials
    • The New York Statewide Breastfeeding Coalition
    • The New York State Chapter of the American Academy of Family Physicians
    • The New York State Chapter of the American Academy of Pediatrics
  • The official kick-off for Great Beginnings NY occurred during five regional webinars during late September and early October, 2013.
  • As of February 2014, the following 67 hospitals providing maternity care services in New York State have joined together to participate in this initiative:
    • Adirondack Medical Center
    • Albany Medical Center
    • Alice Hyde Medical Center
    • Arnot Ogden Medical Center
    • Aurelia Osborn Fox Memorial Hospital
    • Burdett Care Center
    • Canton-Potsdam Hospital
    • Carthage Area Hospital
    • Cayuga Medical Center at Ithaca
    • Champlain Valley Physicians Hospital Medical Center
    • Claxton-Hepburn Medical Center
    • Columbia Memorial Hospital
    • Corning Hospital
    • Cortland Regional Medical Center
    • Crouse Hospital
    • Eastern Niagara Hospital
    • F.F. Thompson Hospital
    • Faxton-St. Luke's Healthcare
    • Good Samaritan Hospital Medical Center
    • Good Samaritan Hospital of Suffern
    • Highland Hospital of Rochester
    • Hudson Valley Hospital Center
    • Huntington Hospital – North Shore LIJ
    • Kingston Hospital – Health Alliance
    • Lawrence Hospital
    • Lewis County General Hospital
    • Mary Imogene Bassett Hospital
    • Massena Memorial Hospital
    • Mercy Hospital of Buffalo – Catholic Health
    • Mercy Medical Center
    • Millard Fillmore Hospital – Kaleida Health
    • Mount St. Mary's Hospital & Health Center
    • Nassau University Medical Center
    • Nathan Littauer Hospital
    • Newark-Wayne Community Hospital Inc.
    • Nicholas H. Noyes Memorial Hospital
    • North Shore University Hospital – Katz Women's
    • Nyack Hospital
    • Orange Regional Medical Center, Middletown
    • Oswego Hospital
    • Our Lady of Lourdes Memorial Hospital Inc.
    • Peconic Bay Medical Center
    • Putnam Hospital Center
    • Rochester General Hospital
    • Saratoga Hospital
    • Sisters of Charity Hospital
    • South Nassau Communities Hospital
    • Southhampton Hospital
    • St. Anthony Community Hospital
    • St. Catherine of Siena Hospital
    • St. Charles Hospital & Rehabilitation Center
    • St. John's Riverside Hospital
    • St. Joseph's Hospital Health Center
    • St. Luke's Hospital of Newburgh
    • St. Mary's Hospital of Amsterdam
    • St. Peter's Hospital
    • Strong Memorial Hospital
    • Stony Brook University Medical Hospital
    • United Memorial Medical Center
    • Unity Hospital of Rochester
    • Upstate University Hospital at Community General
    • Vassar Brothers Medical Center
    • Westchester Medical Center
    • White Plains Hospital Center
    • Winthrop University Hospital
    • Women's Christian Association Hospital
    • Women and Children's Hospital of Buffalo
  • Hospitals that have joined Great Beginnings NY will learn the evidence base supporting the four strategies, focus on best practices, and share their challenges and successes in the implementation of the four strategies.
  • Hospitals interested in participating in this initiative must complete a commitment letter and hospital assurance document. To get a copy of the letter template and assurance form, or to ask questions, contact promotebreastfeeding@health.state.ny.us.