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Breastfeeding Rates Increase in the NJ Baby-Friendly Hospital Initiative

The New Jersey Baby-Friendly Hospital Initiative (NJ BFHI) is an initiative of the New Jersey Department of Health, Office of Nutrition and Fitness and ShapingNJ, the statewide public-private partnership for obesity prevention. It is funded by the Centers for Disease Control and Prevention through the Communities Putting Prevention to Work - State and Territorial Initiative. The American Academy of Pediatrics, New Jersey Chapter and the Pediatric Council on Research and Education (PCORE) coordinated and administered the NJ BFHI.

The NJ BFHI aimed to improve New Jersey maternity care practices and policies in support of breastfeeding with the ultimate goal of reducing obesity. More specifically, the project aimed to:

  • Increase from zero to at least two the number of hospitals designated as Baby-Friendly
  • Master at least two steps from the 10 Steps to Successful Breastfeeding in all grantee hospitals
NJ BFHI Activities

Key project activities included:

  • Project kick-off and statewide summit "Bringing Baby-Friendly to New Jersey: A Challenge to Change"
  • $10,000 mini-grant request for applications
  • Grantee hospital leadership training
  • Ongoing technical assistance
  • Hospital site visits
  • Project-end summit, "Teaming Up to Shape Our Region: A Pathway to Baby-Friendly"
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Key Results
Commonalities in Implementing the 10 Steps
  • Consistent and accurate documentation is critical to the process of implementing the 10 Steps.
  • As maternity care practices make changes in policies and procedures, staff must also make changes their routine practices.
  • Strong steering committees help hospitals implement changes in practices and policies to support breastfeeding.
  • Engaging hospital leadership in the process facilitates cultural change around breastfeeding.
  • Celebrating accomplishments and brining publicity around the process helps to reenergize employees.
  • NJ BFHI formed a collaborative of hospitals that provided peer learning, mentoring, guidance and on-site support to maternity care facilities implementing the 10 Steps.
Mastering the Ten Steps
  • Eight out of 10 hospitals mastered at least two steps and on average, grantee hospitals mastered nearly four steps.

 Baby-Friendly Designation
  • Three grantees received Baby-Friendly Designation.
  • One hospital was designated in March 2012 and two received designation in October 2012.
Changes in Breastfeeding Rates
  • Overall, exclusive breastfeeding rates increased over 11 percent during the project in the grantee hospitals.
  • Rates increased significantly in eight of the 10 hospitals.
  • Exclusive breastfeeding rates in the NICU also increased in some hospitals.
  • A correlation existed between the number of steps hospitals mastered and the rate of exclusive breastfeeding at the end of the project.


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