Thanks to ideas and efforts from nurses and lactation consultants, Rochester's Family Birth Center maintains a higher-than-average rate for newborn access to breast milk.

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The first hour after birth is an important time for mothers who choose to breastfeed their newborns. During this "golden hour," skin-to-skin contact and early latching help the mother and child experience the benefits of breastfeeding and ease what can be a difficult learning experience.

The nursing team at Mayo Clinic in Rochester's Family Birth Center, which includes certified lactation consultants, understands that breastfeeding can be challenging. That's why they regularly bring forward new ideas to enhance support and improve outcomes for their patients.

In the last few years, four ideas from staff have been tested, piloted and launched as permanent programs:

• Promoting an uninterrupted "golden hour" immediately after birth.
• Having breast pumps available at all bedsides.
• Offering a lactation visit for breastfeeding education at 36 weeks of pregnancy.
• Increasing access to donor milk to qualifying mothers and their babies.

"We know that it's always a personal choice to breastfeed or not, which we highly respect," says Rebecca Ashbeck, nurse manager. "Some women who want to breastfeed may face unexpected challenges, making their initial goals difficult to achieve. We help them in any way we can by thinking creatively and providing them with education and resources."

Bedside breast pumps

Skin-to-skin contact during the golden hour stimulates and increases the mother's breast milk production. But for babies who need to be in the neonatal intensive care units, skin-to-skin contact isn't always possible.

"A quality improvement group made up of nursing staff, including IBCLCs (internationally board certified lactation consultants) in Labor and Delivery, explored a couple of practice issues related to early breastfeeding and milk expression," says Pam Geving, a registered nurse in Labor and Delivery. "The team performed an extensive chart review and found an opportunity for mothers who have to be separated from their infants."

Family Birth Center nurses now provide breast pumps and supplies at the mother's bedside to ensure she receives breast milk stimulation within the first two to three hours after giving birth. A pump in each room promotes timely pumping while simplifying nurses' workflows.

Geving's team also developed education for all nursing staff on the importance of milk expression and proper techniques.

Thanks to this simple bedside solution, the Family Birth Center has seen a 20% increase in mothers who expressed milk within the first three hours after birth.

36-week breast milk education

The outpatient Obstetrics Department now offers a lactation education visit at 36 weeks of pregnancy. During the visit, a lactation consultant teaches expectant mothers about the mechanics of breastfeeding and the importance of colostrum and breastmilk, including donor milk. The women learn how to hand-express colostrum, which can be frozen until they give birth.

Rebekah Huppert, a lactation consultant, helped craft the 36-week education visit.

"Many feeding decisions are made before a baby is born. A lactation visit before delivery gave us the chance to educate mothers on the importance of prenatal expression, exclusive breastmilk and the option of using donor milk," she says. "These visits provide an opportunity to connect with families and support them in their breastfeeding journeys."

Homegoing breastmilk

Some newborns require additional feeding supplementation due to supply or specific nutritional needs. Thanks to an idea brought forward by Mayo Clinic nursing staff, families who meet criteria now have access to donor milk after discharge from the hospital.

Donated milk can bridge the gap until the mother's milk supply comes in or until the family is able to buy donor breastmilk. This program also has been adopted by Rochester's neonatal intensive care units.

Supporting workplace, patient care innovations

Thanks to ideas and efforts from the Family Birth Center's nursing team, the center has maintained its rate for exclusively feeding breast milk — and the team is proud that it's been consistently higher than the national average over the past 18 months.

Ashbeck and Heidi Shedenhelm, nurse leaders of the Family Birth Center, say that's because the team is always working to make things better for their patients and each other.

"Staff requested what they needed to elevate care for mothers and babies — to improve patient outcomes and their work environment," Shedenhelm says. "That's just the kind of team we have and the culture that we try to foster. They are always working to elevate the experience for patients, and that spurs even more ideas that benefit our patients and staff."