The numbers are in – and New Hampshire is the winner!

As a Vermonter, I am envious. But I know we’ll be right up there next time.

Ah, you say, The age-old Spat between the States. What’s this one about? Well, if it’s me doing the talking you know – it’s breastfeeding. And the facts revolve around another age-old tale: how you birth does make a difference.

The Centers for Disease Control (CDC) has a breastfeeding staff that includes two superstars, Larry Grummer-Strawn and Katherine Shealy. Back in 2005 they published a CDC Guide to Breastfeeding Interventions – but it was obvious that “interventions” per se weren’t really cutting it. What would truly change the atmosphere for breastfeeding in the United States?

What they found – and designed an educational and practice-changing survey around – is that maternity care practices – the way you birth – make an incredible difference in how the breastfeeding goes, and how long you end up breastfeeding your baby.

Here’s what the CDC says:

  • Skin-to-skin contact –Doctors and midwives place newborns skin-to-skin with their mothers immediately after birth, with no bedding or clothing between them, allowing enough uninterrupted time (at least 30 minutes) for mother and baby to start breastfeeding well.
  • Teaching about breastfeeding –Hospital staff teach mothers and babies how to breastfeed and to recognize and respond to important feeding cues.
  • Early and frequent breastfeeding –Hospital staff help mothers and babies start breastfeeding as soon as possible after birth, with many opportunities to practice throughout the hospital stay. Pacifiers are saved for medical procedures.
  • Exclusive breastfeeding –Hospital staff only disrupt breastfeeding with supplementary feedings in cases of rare medical complications.
  • Rooming-in –Hospital staff encourage mothers and babies to room together and teach families the benefits of this kind of close contact, including better quality and quantity of sleep for both and more opportunities to practice breastfeeding.
  • Active follow-up after discharge –Hospital staff schedule in-person breastfeeding follow-up visits for mothers and babies after they go home to check-up on breastfeeding, help resolve any feeding problems, and connect families to community breastfeeding resources.

New Hampshire’s total score for these practices: 88. Number One in the Nation! (Maine is #2 at 83, and Rhode Island #3 at 81.) Vermont is back away with a 76 – our worst score was in staff training, and almost every nurse in the state just took our new Birth & Beyond Training. So we will catch up next time, right??!!

Meanwhile, the World Health Organization is working on breastfeeding rates around the world, with a program called Baby Friendly. You’ve probably heard of it – and all the nurses in Vermont – including Brattleboro, and with me on the state faculty! – have been getting training in being Baby Friendly. (Talk to our Brattleboro Nurses in Nicaragua for more information about the education they’ve been doing there on this topic.)

There are a couple of other things we know can really help too.

  • Take a breastfeeding class before your baby comes. If a class won’t fit into your schedule, get yourself a good book (two great ones are The Womanly Art of Breastfeeding, 11th edition by West, Weissinger and Pitman, and Breastfeeding made Simple, 2nd by Mohrbacher and Kendall-Tackett) and take a moment to watch Suzanne Colson’s Laid Back Breastfeeding video.
  • If you can, let labor start on its own, and avoid the use of lots of IV fluids. Moms who have a cesarean section after a long induction tend to have challenges with breast swelling (as well as the reduced mobility after surgery). And the best way to get a cesarean is to be a first-time mom who is being induced. So unless there is a medical reason your baby needs to be born, let labor begin on its own.
  • Don’t just keep your baby with you – hold your baby, guard your baby, drink in your baby. Keep your baby out of that little salad bin bassinet as much as you can. Your baby will only smell this good for a very little while, and s/he needs to be colonized with all the flora and fauna you and your partner have. So hug and stroke and kiss that baby – and if your baby still hasn’t breastfed well, don’t let anybody give that baby a bath yet!
  • Get good help. If you feel like you want someone to just sit and encourage, tell your nurse. All area hospitals have not just nurses but IBCLCs – International Board Certified Lactation Consultants – who delight in helping moms learn to breastfeed. Get your questions answered, so you feel like you know yourself and your baby and your breasts before you go home.

Because when all is said and done – you and your baby are the reason we are working hard. We want breastfeeding – and our care for you – to be Mother Friendly in all ways too. Breastfeeding is additively wonderful, and so good for you and your baby. If you choose to breastfeed, we want to help make it work!

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