Maggie McKay (Host): When you're a new mom, you'll take all the support you can get. And that's where Community Memorial Hospital Ventura comes in. They recently earned Baby-Friendly Designation and are here to tell us what that means. Our guests today are RN Sheila Dedrick, Lactation Consultant, and Megan Rodarte, Director of Maternal and Child Health.

Welcome to Wise and Well presented by Community Memorial Healthcare. I'm your host, Maggie McKay. Thank you for being here, Sheila and Megan. Would you please introduce yourselves, Sheila?

Sheila Dedrick: Hi, Maggie. Thank you for having us. My name is Sheila Dedrick. I'm the Manager of the New Parent Resource Center for Community Memorial Hospital. I am a board-certified lactation consultant and a registered nurse.

Host: And Megan?

Megan Rodarte: Hi. My name is Megan Rodarte. I'm the Director of Maternal and Children's Health Services. I've been here at Community Memorial Hospital for 25 years and the Director of the Maternal and Child Health Department for 17 years.

Host: Wow. So, you are the person to talk to about this, for sure. Sheila, could you tell us about the Baby-Friendly Initiative and what it aims to achieve? Why is this initiative so important in the U.S. today?

Sheila Dedrick: Well, the Baby-Friendly Initiative actually started with a collaboration of the World Health Organization and UNICEF, and that was back in 1991. And their goal was to encourage the implementation of what is known as the 10 Steps to Successful Breastfeeding. And incorporated in that is that The International Code of Marketing of Breast Milk Substitutes. So, the use of these 10 steps sets the mother up for breastfeeding success, and it also assists hospitals in giving mothers the information and confidence and skills necessary for the mom to meet her feeding goals. So, that includes education, the parents, and including safe formula preparation and feeding for those who aren't planning to breastfeed.

The benefits to breastfeeding is the reason why it is so important in the United States today. And when you're born in a baby-friendly facility, it's been statistically proven to increase both the initiation and the continuation of breastfeeding. So, you can see why the Baby-Friendly Initiative is so important here in the U.S.

Host: And Megan, can you walk us through the steps Community Memorial Hospital Ventura had to take to achieve the Baby-Friendly Designation?

Megan Rodarte: The process of becoming baby-friendly took us a few years. When we began this journey, we were already implementing most of the 10 steps. But then, we audited ourselves to see where it was we needed to improve and which steps we needed to do more work on. We had already, several years earlier, implemented ski-to-skin contact at birth between moms and their babies or dads, if that's who was available, and in infants rooming in with their mothers.

Other changes that we made were to stop providing patients with free diaper bags that had formula samples. And the hospital began to purchase the formula that is fed to formula-fed infants at our hospital. In addition to patient education, Baby-Friendly has a big emphasis on staff and provider education. Every staff member and provider was given the necessary education that met the Baby-Friendly requirements. Our patient education curriculum was revised to ensure we were teaching parents what they needed to know to be successful. We also rewrote our infant feeding policy to reflect these proven techniques. Baby friendly then came out, and gave us a survey or what felt like an inspection, before they granted us the designation of being a baby-friendly hospital.

Host: Is this the first time Community Memorial has received this recognition?

Megan Rodarte: We first received our designation in 2018, actually, and then we were recently re-designated. The redesignation is required every five years, so that's the process we just went through.

Host: Wow. It sounds like a lot of work, but well worth it. How many hospitals in the U.S. have this accreditation?

Megan Rodarte: Currently, there are around 600 hospitals in the United States that have the Baby-Friendly Designation and approximately 25% of the births in the United States occur in a baby-friendly hospital.

Host: Sheila, the Baby-Friendly Program is not about forcing moms to breastfeed, but creating a supportive environment. Can you talk about the other ways Community Memorial supports new mothers, regardless of their feeding choices?

Sheila Dedrick: Yes, absolutely. This is a cornerstone of BabyFriendly, actually, and we're very proud of this. We educate our parents so they have the information they need to make an informed choice, and then we support them in that choice that they make. Parents receive the necessary education and support while in the hospital and we teach them the basics of breastfeeding or safe formula feeding. Although all of our nurses are trained in providing breastfeeding support and education, we also have specialized lactation nurses who have the highest level of breastfeeding education and knowledge. The International Board-Certified Lactation Counselors, or IBCLCs. And in addition, we have at the New Parent Resource Center, we have the IBCLCs that work exclusively there, that sometimes parents need much more support after they've gone home. So, we provide those appointments for them at no charge.

Host: That's wonderful. Megan, the Baby-Friendly Program follows the 10 steps of successful breastfeeding as you mentioned earlier. Can you break down just a few of these steps and explain how Community Memorial implements them? Just one or two.

Megan Rodarte: Yes, of course. Step 1 is actually broken up into subgroups and this would include our infant feeding policy and that addresses all 10 steps and also complies with the International Code of Marketing of Breast Milk Substitutes. It establishes ongoing monitoring and data collection to ensure we're meeting the established baby-friendly criteria. The policy is key, and of course, we follow our policy. Previous to becoming baby-friendly, we used to receive free formula to use in the hospital as all hospitals did, and we also were given diaper bags from the formula companies that had samples of formula in it, and we would pass those out to our families. We would receive free gifts from these formula companies such as pins, food they'd bring to the nurse's station to create that relationship, and other branded items from these formula companies. We now purchase all the formula that we use. We do not accept any gifts, nor do we give patients gifts from the formula companies. We also monitor our breastfeeding rates. And after becoming baby-friendly, we did see an increase in both our breastfeeding initiation and the exclusive breastfeeding rates.

And then, another step as an example is step four, which is facilitating immediate skin to skin contact between baby and mom after birth and initiating breastfeeding as soon as possible. We used to think that babies needed to be taken to a warmer to be assessed and welcomed into the world. What we know now is that babies regulate their temperature and their blood triggers better when they're actually skin to skin. This also increases breastfeeding through a process called biological nurturing. In other words, we're putting babies and moms in a situation where the baby's natural reflexes are stimulated, creating the baby to want to go to breast and initiate breastfeeding.

Host: What are some of the well-documented benefits of breastfeeding for both moms and their newborns? And how does Community Memorial educate expecting and new moms about these advantages?

Megan Rodarte: To quote Baby-Friendly USA, breastfeeding is the biological norm for all mammals, including humans. Exclusive breastfeeding for six months provides the nurturing, the nutrients, and the energy needed for physical and neurological growth and development of the newborn. Since breast milk has antibodies, it helps to protect the baby against some short and long-term illnesses and diseases. This includes a lower risk of asthma, obesity, type 1 diabetes, and sudden infant death syndrome. Also, ear infections and stomach bugs, the frequency of that is reduced when the child is breastfeeding. And maternal benefits of breastfeeding a child include reducing the risk of breast and ovarian cancers, type 2 diabetes, and high blood pressure.

Sheila Dedrick: Another example is step nine, which includes counseling mothers on the use and the risks of bottle feeding, artificial nipples, and pacifiers. The reason we do this is studies show that babies who are given formula will not breastfeed as often. You can imagine because their tummies are getting full. This in turn can decrease the milk supply as the baby's signal to make milk when the baby breastfeeds. The first month is especially important for this supply and demand. The more the baby demands, the more milk the mom will make. If the baby fills up on formula, then the demand will not be as much as the breastfeeding, and the body will make less breast milk.

In addition, giving a baby a pacifier or a bottle nipple before breastfeeding, as well established, can interfere with baby latching to the breast. Babies can become dehydrated or have poor weight gain with early pacifier use as they might be pacified back to sleep when they should be eating. For these reasons, unless medically necessary, we recommend exclusive breastfeeding. We also recommend no pacifier use until the baby is three to four weeks old, and breastfeeding is well-established.

Host: Sheila, what resources and support does Community Memorial offer to new families, both in the hospital and after discharge, to kind of help them continue their breastfeeding journey?

Sheila Dedrick: We offer a multitude of support groups and classes at our New Parent Resource Center to help our new parents in their journey to parenthood. During pregnancy, we offer prepared childbirth classes, hypnobirthing, and prenatal yoga. Recognizing that one in five women have postpartum mood disorder, we offer an emotional support group and hypnomothering class in addition.

Our eight-week series, Our Babies, Ourselves, helps with that transition into being a new parent, and we also offer CPR and breast pumping class. Continued support is so very important for breastfeeding. We staff international board-certified lactation consultants that provide private lactation consults by appointment. Our patients who deliver at CMH are able to make unlimited appointments at no charge for the first year of their baby's life. And for those who delivered elsewhere, there's a nominal fee for that same level of support.

Host: That's amazing. Because, like I said in the beginning, you need all the support you can get, especially when you're breastfeeding. And can I just add, I just have to know, so many people say when they were breastfeeding, they've never been thinner in their lives. What's that about?

Sheila Dedrick: Well, did you know that for every ounce of breast milk, it has an average of 20 calories? So, think about all those calories that you're making. That doesn't give you license to just eat junk food. You still want to continue with a healthy diet because not only are you nurturing your baby, but you're also continuing your own health. So, it is important to make good health choices, but breastfeeding can be very helpful in that way.

Host: Yes. Megan, what are some of the goals for the Community Memorial Maternal and Child Health Department?

Megan Rodarte: Well, our labor and delivery staff have been educated in specific labor support techniques that help with labor progression and descent of the baby through the pelvis. One of those specific techniques we use is called spinning babies and that helps the nurse identify and help babies that may not be in an optimal position for birth to turn and come on out. This can help reduce the risk of patient needing a cesarean section.

And so, we have a lot of other tools that we use for labor support, such as music. We have low lighting and we have these little candles that are not really a flame. We have peanut bowls and birthing bowls. So, we have quite a bit of tricks to help labor support and progression of labor. We also are offering skin-to-skin in the OR for those patients that require a cesarean birth.

We've restarted our in-person maternity tour so that those who are delivering at CMH can come on in and see the hospital before the time of admission. And if anybody wants to participate in that, you call the New Parent Resource Center at 805-948-BABY, and you can register for a tour. We also have a virtual tour on our website and a tour of the NICU at mycmhbaby.org. Additionally, two of our staff members are on the Board of Breastfeeding Coalition of Ventura County and this is instrumental at the legislative level to protect and support breastfeeding.

And the newest initiative I'm so proud to announce in our department is the Midwife Program. Patients can see a midwife now in our clinic system and also have a midwife delivery. This program is through our Centers for Family Health clinics and we're very proud and excited to see improved access with the addition of these midwives.

Host: Well, thank you both so much for sharing your expertise. We really appreciate you making the time. And I, for one, have learned a lot today.

Megan Rodarte: Thank you so much. We appreciate it. And we had a great time sharing with you all the great things that we have to offer here at Community Memorial Hospital for those that are ready to welcome a new baby into their family.

Sheila Dedrick: Yes, Maggie. Thank you for having us. And as Megan said, if anybody's interested in classes or tours, they can see mycmhbaby.org or call us here at the New Parent Resource Center.

Host: Thank you both. Again, that's Sheila Dedrick and Megan Rodarte. To learn more, please visit mycmhbaby.org. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to Wise and Well presented by Community Memorial Healthcare.