June 15, 2018

In North Carolina and South Carolina, a new effort is aimed at improving maternity care and breastfeeding rates in underserved areas – and helping babies get the healthy start they need.

Developed by the Carolina Global Breastfeeding Institute (CGBI), housed within the UNC Gillings School of Global Public Health, the new ENRICH Carolinas project will help 20 hospitals and their affiliated prenatal clinics earn a Baby-Friendly Hospital designation from the North Carolina Maternity Center Breastfeeding-Friendly Designation program. This recognition means that a maternity center has taken significant steps to promote, protect and support healthy breastfeeding.

Catherine Sullivan

Catherine Sullivan

“We have the potential to make an impact on more than 25,000 births in the Carolinas by increasing the number of hospitals that make it easier for new mothers to breastfeed,” said Catherine Sullivan, MPH, director of the Carolina Global Breastfeeding Institute. “The generations touched by the ripple effect of this work will be far-reaching.”

An $830,000 grant from The Duke Endowment is funding the effort as part of the Endowment’s emphasis on early childhood interventions.

Experts agree that breastfeeding is a major determinant of long-term health outcomes. The American Academy of Pediatrics supports the “unequivocal evidence” that breastfeeding protects against a variety of diseases in infants, including diarrhea, respiratory tract infection and childhood obesity.

In “The Surgeon General’s Call to Action to Support Breastfeeding,” the U.S. Department of Health and Human Services reports that breastfeeding also benefits the mother, reducing her risk of breast cancer by 4 percent for each year she breastfeeds and reducing her risk of ovarian cancer by 27 percent.

While breastfeeding rates are rising in the United States, they’re still low, especially among low-income and minority women. The concept of Baby-Friendly Hospitals – and the ENRICH Carolinas project – were conceived with this information in mind.

Baby-Friendly Hospitals follow procedures that optimize mother-baby bonding and promote breastfeeding, such as encouraging mothers to hold their babies skin-to-skin immediately following birth. So far, more than 500 hospitals and birthing centers in the United States have earned the Baby-Friendly designation, including 14 facilities each in North and South Carolina.

To support the ENRICH Carolinas project, which began in January 2018, CGBI is collaborating with Population Health Improvement Partners to provide on-site coaching, host learning collaboratives and webinars, and offer technical assistance for hospitals moving through the designation processes. The Institute also will offer training to affiliated prenatal clinics, child care providers and community leaders, and will address the support moms need after they leave the hospital and return home.

ENRICH Carolinas’ initial goal is to work with up to 20 hospitals that have signed on to complete the designation. Becoming Baby-Friendly is complex and time-consuming, and many facilities, especially in underserved areas, need outside support to be successful.

“Our coaching is all about taking the fear out of moving through the designation,” Sullivan shared.

Looking forward, the researchers at CGBI would like to help all hospitals in the Carolinas earn Baby-Friendly status. Experts believe that would be the first time for every hospital in one state – let alone two states together – to achieve the designation. Sullivan estimates that some 100 facilities in North Carolina and South Carolina have not yet achieved Baby-Friendly status.

The original version of this article was published by The Duke Endowment.


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