Andrea Serano works with CHAMPS (Communities and Hospitals Advancing Maternity Practices). Andrea discussed the Health Care Action Areas of the Surgeon General's Call to Action to Support Breastfeeding during the August 18 virtual town hall meeting. Below is a transcript of her responses:
What accomplishments from the five years since the SGCTA are you most excited about? Did these efforts target or affect disproportionately impacted populations, i.e., those with the greatest disparities in breastfeeding rates? If so, how?
I am most excited about all the work that has been going towards addressing Baby-Friendly hospitals, or if anything, practices that align with the ten steps of being Baby-Friendly. What we’ve been seeing is that you have Best-Fed Beginnings, you have CHAMPS, you have EMPower, and then you have state and local initiatives that have been going forward to address policy changes.
Being a complete seed from my mentor, Ms. [Kimarie] Bugg, she always says that “providers look at what is policy, what is the policy.” So, when you see that the strong initiative towards changing hospital policies around maternity practices to support mother-infant bonding, which of course holds in breastfeeding, it’s setting those foundational practices that will hopefully continue to be sustainable, because once you change that hospital policy, that must remain.
I am probably wearing the most appropriate shirt for this discussion, with “Louisiana Eat Local.” What that ties into is that we’ve been doing work with CHAMPS (Communities and Hospitals Advancing Maternity Practices) through Boston Medical, focusing on New Orleans, Louisiana, Mississippi, and parts of Tennessee, and of course Southern Texas. With this initiative, it’s been going forward to help hospitals’ policy changes so that way they can go and apply for Baby-Friendly designation.
When we look at what the past rates were for states in the south, for breastfeeding rates, or even access to Baby-Friendly hospitals, the rates were really low, so in these past years, we’ve seen tremendous changes where we have 16 hospitals in Mississippi that are a part of the CHAMPS initiative, there’s eight in New Orleans that are part of this initiative, five in Texas, two in Tennessee, that are going through this initiative to change their policies to address mother-infant bonding. I think that’s the most exciting part, to see how far the needle has really gone.
Considering the focus of the USBC and the field on advancing equity in breastfeeding support, what is missing from the SGCTA that you see as an important priority for the next five years?
I wouldn’t necessarily say completely missing, but what needs to be a little bit more looked at is the work around doctors’ offices. There are tons of initiatives addressing hospital changes and birth centers, but when we also consider that equity lens, where mothers go for their pre-natal services is often times in the doctor’s offices for most of their pregnancy before going to the hospital for two or three days, depending on their delivery. Possibly putting more emphasis and focus on doctor’s offices to make sure that moms are getting this education, hearing about breastfeeding directly from their provider, much sooner.
I know we’re talking about the health care perspective, but when we align into the work ROSE (Reaching Our Sisters Everywhere) does with Community Transformers, we ask, “How many of your providers talked to you about breastfeeding prenatally?” We want to get to a point where everyone’s hands are raised and not necessarily one or two. Slowly, in the room, through the changes that have been occurring over the past few years, we have started seeing more hands go up, in comparison to the beginning of our community training. So, I would say just an emphasis, a little bit more, on doctors’ offices.
Looking at the whole (both existing action areas and any new ones suggested), which three implementation strategies do you think would have the greatest impact if prioritized over the next five years? How could these strategies best apply an equity approach?
Getting doctor’s offices more on board. And, I know 8 [Continuity of Care] wasn’t included under my scope, but I’m still going to mention it. That community engagement piece, where there is truly some connections between hospitals and doctor’s offices with the community and community resources, because still yet, we are having moms, you know they might get a list, hopefully, a list of resources within the community, but there needs to be a little more stronger bonds formed where it’s a little bit more than a list and they can see that the community resources are truly tied in with the local hospitals.
And, of course, ensuring that these hospitals going through these policy changes are also in communities with vulnerable populations. When we were at the USBC conference, and everybody read an overview of the miraculous work that’s been going on, it still was mentioned that the disparity gaps between African-Americans and other ethnic groups are still widening. There’s something there that needs to be addressed.