6 for ME: Maine Takes 6 Steps to Improve Breastfeeding
The 6 for ME initiative provided support to Maine healthcare professionals and birth hospitals to adopt six of the evidence-based "The Ten Steps to Successful Breastfeeding". Breastfeeding outcomes are dose dependent on the number of steps a hospital implements. Implementing at least six of the ten steps has the greatest impact on breastfeeding outcomes short of implementing all ten steps. The long- term goal of 6 for ME has been to increase breastfeeding duration and exclusivity in Maine.
The 6 Steps
- Have an evidence-based written breastfeeding policy that is communicated to all healthcare staff.
- Train all healthcare (maternity and labor and delivery) staff in skills necessary to assist mothers and babies to breastfeed and to implement the breastfeeding policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Give infants only breastmilk, unless medically indicated.
- Practice 24-hour "rooming in" to allow mothers and infants unlimited access to each other.
- Foster the establishment of breastfeeding support groups and refer mothers to them at discharge.
*See below for resources for implementing the six steps.
6 for ME Webinar Series
Created for Maine healthcare professionals caring for mothers and babies.
- The Epidemiological Evidence for the Benefits of Exclusive Breastfeeding - Presented by Alison Holmes, MD, in August, 2014
- Why Provider Ed Matters & 10 Steps Impact on Breastfeeding Success - Presented by Bonny Whalen, MD in September, 2014
- Prenatal Education - Finding Strategies that Work - Presented by Bonny Whalen, MD in October, 2014
- Maine & NH's Breastfeeding Efforts 2013-2014 - Presented by Bonnie Whalen, MD in December, 2014
- Texas Ten Step Star Achiever Program This website is rich with tools for implementing each of the six steps. Check out the Texas Ten Step Star Achiever Program and Toolkit.
- Texas Ten Step Videos A series of five-minute videos providing an overview of each step.
- NICHQ Safe Sleep & Breastfeeding Resources National Institute for Children's Health Quality (NICHQ) shares resources for making safe sleep and breastfeeding the norm, and for ensuring families receive consistent, evidence-based information.
- Baby Friendly USA Guidelines and Evaluation Criteria The guidelines represent the standard of care that facilities should strive to achieve for all patients for each of the Ten Steps to Successful Breastfeeding. The evaluation criteria represent the minimum standard that a facility must achieve in order to become Baby-Friendly designated.
- LACTMED Drug and Lactation Database: Drugs and other chemicals to which breastfeeding mothers may be exposed.
- Maine State Breastfeeding Coalition (MSBC): The MSBC is a welcoming and broad network of people supporting families who value human milk and breastfeeding. Together we work to enhance the culture of breastfeeding around the state through professional networking, advocacy, and education.
Step-Specific Resources for the 6 for ME Steps
1: Have an evidence-based written breastfeeding policy that is communicated to all healthcare staff.
- Developing a Comprehensive Breastfeeding Policy, J Kelly, 6.1.16
- AAP Sample Hospital Breastfeeding Policy
- New York State Model Breastfeeding Policy
- California Breastfeeding Model Hospital Policy Recommendations On-Line Toolkit
- Summary: https: of Marketing Breastmilk Substitutes
- International Code of Marketing Breastmilk Substitutes
- Texas Ten Step Star Achiever Program
2: Train all healthcare staff in skills necessary to assist mothers and babies to breastfeed and to implement the breastfeeding policy.
- Maryland’s Maternity and Physician Provider Webinars The Maryland Hospital Breastfeeding Policy Committee coordinated a Free 15 hour didactic module for maternity nurses and a Free six-lecture series of Free webinars for providers that meets the requirement for Step 2 of the Ten Steps to Successful Breastfeeding and the Baby Friendly Hospital Initiative. Cost: Free
- New Hampshire’s Ten Steps to Successful Breastfeeding Online Curriculum One year license is available for $250 and may be accessed by as many staff as needed to complete the 15 hours of the World Health Organization (WHO) recommended breastfeeding curriculum.
- Texas Ten Step Star Achiever Program
- Expanding Clinicians' Roles in Breastfeeding Support This 1.5 hour tutorial in combination with the 1.5 hour tutorial below provide 3 hours of breastfeeding education that is aligned with the content expected for physicians providing care in facilities implementing the Ten Steps to Successful Breastfeeding or are designated as Baby-Friendly facilities. Continuing Medical Education (CME) Online Tutorial (CME#1) 1.5 CME Cost: Free
- Expanding Clinicians' Roles in Breastfeeding Support: Focus on Maternal & Infant Care Prenatally and During Hospital Stay This 1.5 hour tutorial in combination with the 1.5 hour tutorial above provide 3 hours of breastfeeding education that is aligned with the content expected for physicians providing care in facilities implementing the Ten Steps to Successful Breastfeeding or are designated as Baby- Friendly facilities. Continuing Medical Education (CME) Online Tutorial (CME#2) 1.5 CME Cost: Free
- American Academy of Pediatrics Section on Breastfeeding List of Educational Courses and Materials A list of breastfeeding educational courses for providers, some offer CMEs, some are Free and many are available on line.
- American Academy of Pediatrics Physician Education and Training Breastfeeding Action Plan (2018) The AAP developed a comprehensive action plan that includes recommendations for addressing: (1) gaps in breastfeeding training and education for physicians, with special emphasis on underserved populations and (2) training to support the safe implementation of evidence-based maternity practices supportive of breastfeeding.
- Bella Breastfeeding: Provider Training Bella Breastfeeding: Provider Training is a peer-reviewed online course on OPENPediatrics, a free web-based digital learning platform designed for health care professionals around the world. The purpose of this course is to fulfill the requirement for provider education as outlined in the Baby-Friendly USA Guideline and Evaluation Criteria manual. Three hours of training are required for providers (Physicians, Midwives, Physician Assistants and Adv. Practice Registered Nurses.)
- Academy of Breastfeeding Medicine Protocols ABM Publishes Protocols To Facilitate Best Practices In Breastfeeding Medicine. Translated protocols undergone a rigorous two-way translation to provide complete accuracy.
- Communities and Hospitals Advancing Maternity Practices (CHAMPS) CHAMPS, in collaboration with the Mississippi State Department of Health, hosts a series of webinars on key topics in evidence-based maternity care and infant feeding practice.
- Wellstart International Breastfeeding Study Modules Wellstart International's mission is to advance the knowledge, skills and abilities of health care providers regarding the promotion, protection and support of optimal infant and maternal health and nutrition from conception through the completion of weaning.
- International Institute of Human Lactation, Inc Health e-learning provides quality continuing education for lactation specialists and anyone else looking to enhance their breastfeeding education. Study when it's convenient to you 24/7/365 with certificates issued immediately upon successful completion of each course.
- Contact for more information: firstname.lastname@example.org
3: Inform all pregnant women about the benefits and management of breastfeeding.
4: Give infants only breastmilk, unless medically indicated.
- Acceptable Medical Reasons for Breastmilk Substitutes WHO, 2009
- Texas Ten Step Star Achiever Program
- USBC Toolkit: Implementing The Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding
- ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017
5: Practice 24-hour "rooming in" to allow mothers and infants unlimited access to each other.
6: Foster the establishment of breastfeeding support groups and refer mothers to them at discharge from the hospital.