Labor Repose

Labor Repose
LaborPayne during her 6th homebirth (9th baby) at age 44

Friday, August 28, 2009

Hannibal Regional Hospital is Baby Friendly!

Yesterday I made the four hour drive to and from Hannibal MO to participate in the celebration for the their Baby Friendly designation. It was easily worth 8 hours on the road. What a victory to relish! I traveled with Charlene and Mary Grace, two veteran lactation consultants here in the KC area. Charlene and I are both on the Missouri Breastfeeding Committee and Greater KC Breastfeeding Committee. I also serve on the Kansas Breastfeeding Committee. As a crowd gathered in the lobby of the hospital I couldn't help but think, that most of those gathered probably didn't understand the long term consequences of what was happening here. Baby Friendly sounds so warm and fuzzy, that most folks don't realize the long term implications of making such cultural changes in a facility. There was a brief ceremony presenting the plague with the media and all the administrative bigwigs present. Afterwards, us traveling dignitaries were given a tour of the maternity care unit. (It was actually a large, attractive fairly new facility). My favorite part of the day came next. We were treated to a powerpoint presentation from the lactation consultant about the facility's 5 year journey to Baby Friendly. It was a long and tumultuous journey to say the least. Afterwards we attended a reception. This was my second favorite part. I put on my advocate hat, and sat at a table with the hospital administrators and talked with them about how this small designation is going to impact the health of their community for years to come. I wanted them to know what a big deal this was, and not just 'another certificate'. I talked about my thesis topic: the impact of lactation on infant mortality rates in the African American community. They asked lots of questions about breastfeeeding, birth practices, and cultural competency. I actually had a great time. On the car ride home Charlene said it was the best day she's had in a long time- and I would have to agree!
Thanks Hannibal Regional Hospital for showing the SHOW ME state how it's done!

Wednesday, August 26, 2009

Hey Kansas- Got Milk?

It's official. Missouri has it's first 'Baby-Friendly Hospital' a designation assigned by the World Health Organization for hospitals that meet it's 10 criteria for supporting lactation. The hospital is in Hannibal MO (yes, that town of Tom Sawyer and Huckleberry Finn fame). I will be traveling there tomorrow for the day (about 3 hours from KC) to be a part of the celebration planned to recognize this momentous occasion. I'm so excited. A barrier has been broken. Neither state of Kansas or Missouri had a baby friendly hospital (or a mother friendly one either- a designation from CIMS (Coalition to Improve Maternity Services) for natural birth support). It was often a topic of discussion when attending my Kansas or Missouri breastfeeding committee meetings, and Kansas City breastfeeding committee meetings. It will be nice to be surrounded by my bi- state-wide breastfeeding advocates to celebrate this occasion, and to brainstorm ways to make it happen closer to home.

The hospital in Hannibal has successfully completed these 10 steps:

The Ten Steps To Successful BreastfeedingThe BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States are:
1 - Maintain a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
3 - Inform all pregnant women about the benefits and management of breastfeeding.
4 - Help mothers initiate breastfeeding within one hour of birth.
5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 - Give infants no food or drink other than breastmilk, unless medically indicated.
7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 - Encourage unrestricted breastfeeding.
9 - Give no pacifiers or artificial nipples to breastfeeding infants.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

PS: For American hospitals number 6 is the bug-a-boo. Most hospitals are absolutely dependent on the free formula they recieve from formula companies, and the free diaper bags full of free formula given to patients. Most hospitals can't see giving this up to qualify for the designation. Of course, the short-sightedness of this view of things is, if you truly support and maintain lactation, you won't need the free formula.

Saturday, August 22, 2009

Baby Friendly Missouri

Yippee! Missouri has it's first Baby Friendly Hospital in Hannibal Missouri. This is a designation from the World Health Organization for hospitals that comply with the 10 objectives for becoming Baby Friendly (or breastfeeding supportive). (Find more info at http://www.babyfriendlyusa.org ) My breastfeeding advocate cronies and I will be traveling to Hannibal next Thursday for the festivities, and the satisfaction of knowing the a barrier has been broken. Since I worked labor and delivery at several local hospitals over the years, I know that our local facilities do a poor job of supporting lactation. I saw most of the things on this list often ignored and downright counteracted. It's exciting to know that there's a hospital somewhere in the state getting it right.


The Ten Steps To Successful BreastfeedingThe BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States are:
1 - Maintain a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
3 - Inform all pregnant women about the benefits and management of breastfeeding.
4 - Help mothers initiate breastfeeding within one hour of birth.
5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 - Give infants no food or drink other than breastmilk, unless medically indicated.
7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 - Encourage unrestricted breastfeeding.
9 - Give no pacifiers or artificial nipples to breastfeeding infants.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

FIMR Visit

I attended a FIMR meeting last week, and it was terrific. This is a federally funded program designed to decrease infant mortality. The case review team (which I attended) is made up of various maternal child health professionals that review actual cases of infant deaths in areas (by zip code) that have the highest number of infant deaths. The FIMR coordinator conducts an interview with the mother, and gathers medical data from hospitals and doctor's offices. She brings her reports to the meetings and we discuss them case by case. The goal of the group is to provide recommendations to close any gaps in services that may have impact on decreasing future deaths. These recommendations go to the community action team to enact. Most of the cases we heard at last week had a lot of the same sad factors, young moms delivering prematurely. What I found heartening about the whole thing was that someone somewhere was addressing the problems, analyzing the issues, seeking potential solutions. I'd like to continue attending just to keep an ear to the ground.

Friday, August 14, 2009

FIMR

I've been getting these invitations to attend a FIMR meeting. I've known about them since they started several years ago, but I've not attended one. FIMR stands for Fetal Infant Mortality Review. This group of neonatal and maternal health professionals is charged with critically examining all the fetal deaths within certain high risk zip codes in our city to determine why these babies are dying, and what can be done preventitively to decrease the number of deaths. How cool is that? There is a case review team (whose meeting I will be attending) and a community action team that work to enact the recommendations of the case review team. Their work is overseen by the city Health Commission, the women and infant's health committee- my newest membership. Can't wait to check things out to see how it all works.

Wednesday, August 12, 2009

News

Louisa aka Mama Midwife came to visit my class of OB nursing students. She was wonderful. The students loved her storytelling, and her video of her waterbirth, and her sweet little baby boy. She was fab.

World Breastfeeding Week (Aug. 1-7) has come and gone. I usually write a letter to the editor of the local paper, but I was busy and forgot. What I did do was attend a very nice educational event that the Breastfeeding Committee I sit on, planned for our annual event. We had a local midwife speak on breastfeeding during a disaster. It was a superb presentation about the role of lactation during disaster planning. I was downright inspired! I've been toying with writing a curriculum ever since! I've spent enough time with disaster planners now (when I did speaking for pay last year) to know they don't know squat about maternal/child health as it relates to disaster planning.

Attended a local meeting a of new group forming here in KC. It's called the Kansas City Birth Network. It's a unique idea by some of my birth community cronies (I really am fortunate to live in a city with such an active birth and lactation community). The group of birth professionals meets monthly to hold a forum for the public and answer questions and present little mini seminars about birth and lactation related issues. The first meeting drew a nice little crowd of pregs and new mamas. The best part of attending meetings like that is the networking that happens afterward, and just being around 'my kind.'