HealthEast hospitals embracing a 'baby-friendly' approach to birth

Zane Khouli was born at 12:15 p.m. Thursday with a full head of brown hair. Immediately afterward, before getting weighed or tested, Zane rested against his mother's chest.

"We've been waiting for nine months for this moment," said Zane's mother, Michele Khouli, of Woodbury. "We didn't want to take that away."

Zane was born at Woodwinds Hospital in Woodbury, which is making a concerted effort to ensure that mothers like Michele Khouli have direct, "skin-to-skin" contact with their newborns and immediately begin breast-feeding.

The new practices and emphasis on breast-feeding education are a result of HealthEast's two-year process to receive national certification as a "baby-friendly" birth facility, which required 20 hours of education for all nurses and a minimum of three training hours for each of the 400 providers, said Carol Busman, clinical nurse specialist for the HealthEast Maternity Care Center.

The system's three hospitals — Woodwinds, St. Joseph's in St. Paul, and St. John's in Maplewood — were officially certified last week under the Baby-Friendly Hospital Initiative, a program sponsored by the World Health Organization and the United Nations Children's Fund. Only 7.6 percent of hospitals in the country have the certification, and HealthEast is Minnesota's first systemwide, baby-friendly hospital group.

One of the driving forces for HealthEast's certification was improving exclusive breast-feeding rates for new mothers, said Jeanette Schwartz, Woodwinds maternity clinical director. Although 90 percent of mothers at HealthEast were initiating breast-feeding after delivering, only about 40 percent were exclusively breast-feeding once they left the hospital. Nurses and doctors were giving out too many formula supplements to newborns, Schwartz said, a habit practiced by many providers in the state.

"When you're saying breast-feed and you're giving formula samples, it's incongruent," said Mary Johnson, breast-feeding coordinator for the Minnesota Department of Health's Women, Infants and Children Program.

The hospital also has purchased human donor breast milk from an accredited milk bank in Ohio, Schwartz said.

But because of improved breast-feeding rates, babies need less formula and less milk, reducing costs for hospitals. Almost 60 percent of mothers at HealthEast now breast-feed exclusively at three months, and almost 50 percent at six months.

The new HealthEast certification reflects a larger statewide effort to promote healthier maternity practices — boosted in August for National Breastfeeding Month. State Health Commissioner Dr. Ed Ehlinger is sending letters to hospital executives calling on them to promote optimal maternity care and consistent breast-feeding by implementing 10 steps identified by the World Health Organization.

The steps include providing staff training, helping mothers initiate and continue to breast-feed, and keeping mothers and infants together 24 hours a day.

Hennepin County Medical Center has been working toward its own baby-friendly certification, and since the beginning of its program has increased the percentage of mothers exclusively breast-feeding in the hospital from 24 percent to 62 percent, said Dana Barr, a family medicine staff physician at the HCMC Richfield Clinic. Mayo Clinic Health System-Austin in Austin, Minn., and the University of Minnesota Children's Hospital in Minneapolis also received the certification in 2011 and 2012, respectively. Regions Hospital in St. Paul also is seeking its certification.

Breast-feeding is associated with decreased risk for infant illness and mortality. Recent studies estimate that if 90 percent of women breast-fed exclusively to 6 months, and up to a year or more with complementary foods, the country could save $13 billion in annual health care costs.

For HealthEast mothers, the baby-friendly designation is not just about breast-feeding — it's about creating a better initial connection with their baby.

Melissa Scalia, of Blaine, delivered her third baby, son Isaac, by Caesarean section at St. John's Hospital five months ago. Afterward, she felt immediately more relaxed than she had in her first two deliveries, she said. This was the first time she was able to have immediate skin-to-skin contact, as part of HealthEast's initiative.

Instead of keeping Scalia's arms strapped after her operation, the nurses, obstetrician and anesthesiologist used their training to position Isaac next to his mother. Isaac has begun breast-feeding quicker and better than Scalia's previous children, in part thanks to the initial contact on her chest.

"It was the first time I was actually able to hold one of my kids right away," Scalia said.