Family Birth Center
The first Baby Friendly™ facility in Monterey County
By far, the majority of women who have babies at Community Hospital of the Monterey Peninsula continue to breastfeed their newborns after they leave the hospital. In fact, the rate hovers around 97 percent, a figure that far surpasses national levels.
The hospital takes pride in this figure. As a growing body of scientific evidence continues to show the overwhelmingly positive health effects of nursing babies, the hospital has gone one step further to promote breastfeeding among its patients.
Earlier this year, Community Hospital passed a rigorous voluntary certification inspection and received the distinction of being named a Baby Friendly hospital, only the 41st in the country, one of just eight in California, and the first in Monterey County. It was a 13-year process that started with Community Hospital obtaining its Baby Friendly certificate of intent in 1991. “This recognizes the great work our staff has done,” says Debbie Gill, R.N., director of the hospital’s Family Birth Center. “And it lets our community know all we do to support breastfeeding.”
Sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), the Baby-Friendly Hospital Initiative (BFHI) is designed to encourage and recognize hospitals and birth centers throughout the world that offer optimal levels of care for lactation.
“Community Hospital’s achievement is a wonderful thing,” says Cindy Turner-Maffei, national BFHI coordinator. “The hospital has demonstrated its commitment to mothers and babies and, alternatively, to the whole community.”
It wasn’t an easy process, Gill says. It took years of preparation, staff training, continuing education, onsite interviews, and coordinated teamwork between doctors, administrators, and nurses to achieve the designation. Monterey County has also honored Community Hospital with a resolution from the Board of Supervisors congratulating the hospital on its distinction as the first Baby-Friendly birth facility in the county.
“We decided we wanted to go for certification because it was best for our patients,” says Trina Ammar, R.N., a board-certified lactation consultant and lactation service coordinator at the hospital. “We wanted our staff to have the best education possible.”
The push toward increased breastfeeding among mothers isn’t new at Community Hospital. Changes have been occurring gradually for years, along with a cultural change within our society, Gill says.
A generation ago most babies were formula-fed, so today many of the hospital’s new mothers were raised on formula themselves. Because breastfeeding advice may not be available from family or friends, it often has to come from the hospital.
In a true testament to staff effort and committment, the Family Birth Center is one of only 41 Baby Friendly™ hospitals in the country.
(Front row from left) Tricia Markusen, M.D.; Loida Matulac, R.N.; Angel Look, R.N.; Mae Zarkesh, R.N.; Michelle Savage, R.N.; (back row from left) Debbie Travaille, R.N.; Sally Schmidt, R.N.; Trina Ammar, R.N., patient educator; Bonnie Benadom, unit receptionist; Kathleen Howe, R.N., clinical instructor; Debra Heisel, R.N.; Sandra Negrete, unit receptionist.
Health Benefits
Encouraging women to breastfeed their babies has been a growing trend at Community Hospital the past 15 years, due to the increasing scientific evidence of the health benefits of lactation. Studies now show that, when compared with breastfed infants, babies who are not breastfed are:
- six times more likely to be hospitalized for inner ear infections
- three times more likely to get asthma
- more likely to suffer from a childhood cancer
- more likely to develop type 1 diabetes
In addition, mothers who breastfeed have been found to have lower incidences of breast cancer than those who don’t. Community-wide benefits include healthcare cost savings from decreased hospitalizations and doctor visits.
Other health benefits include lower rates of obesity among breastfed children, a decrease in cases of diarrhea, and fewer childhood allergies.
“As studies clearly show, breast milk is best for babies,” Gill says.
Among the steps taken to encourage and support breastfeeding, Community Hospital doesn’t give water or formula to babies immediately after birth. Also, the newborn isn’t taken immediately to the nursery. Instead, it is left with the mother, who is encouraged to “room in” with the baby 24 hours a day.
“You learn to read your baby’s cues much better if there’s immediate bonding,” says Zosia Chciuk, R.N., assistant director of the Intermediate Intensive Care Nursery (IICN) and board-certified lactation consultant. “Truly, it’s a different experience when you’re holding and breastfeeding your baby. Because nursing takes awhile, it slows you down in a good way. In the long term, our culture benefits. Kids are healthier. Cultures have been doing this for thousands of years. Our bodies were made to do this.”
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Baby Friendly Hospital Initiative Requirements
- Hospital staff helping mothers whenever possible to initiate breastfeeding within one hour of birth.
- Hospital staff informing all pregnant women about the benefits and management of breastfeeding, and showing mothers how to breastfeed and how to maintain lactation, even if they are separated from their infant.
- Avoiding the distribution of pacifiers and artificial nipples to newborns because they can discourage nursing.
The hospital has had written policies for most of these procedures since 1991. The BFHI requires offering education courses like those already taught by Robin Nickerson, a nurse in the IICN and a board-certified lactation consultant. Her courses include a prenatal breastfeeding class and a course on pumping and storing breast milk for moms who plan to return to work.
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Educating Parents
Educating parents is essential for the success of the program, according to staff. And that means not only mothers but fathers and significant others as well.
While hospital support is important, continuing that support once a mother returns home is crucial to the success of long-term breastfeeding practices, Ammar says. And for maximum health benefits, it is recommended that babies be breastfed for at least a year. The American Academy of Pediatrics (AAP) recommends breastfeeding babies exclusively until they are 6 months old, and continuing until they are 1 year old, with the addition of complementary foods. The World Health Organization recommends that babies be breastfed for at least two years.
“It has to be a team effort,” says Chciuk. “New mothers generally need support from both hospital staff and family. It just can’t be one-sided. The staff spent a lot of time getting more informed and becoming aware of how to help moms be successful at breastfeeding. Doctors and administrators, everyone has been committed.”
Lack of information is the biggest reason for low breastfeeding rates, says Gill. And Community Hospital is determined to try to eliminate that barrier.
“You just can’t make anything better than breast milk,” says Ammar. 
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Born prematurely to a teenage mother, the odds were against 2-week-old Isaiah becoming a breastfed baby.
But 16-year-old Jennifer Torre of Pacific Grove chose to have her baby at Community Hospital of the Monterey Peninsula. Recently designated a Baby-Friendly™ hospital, Community Hospital is now required to encourage successful breastfeeding among its patients. And for baby Isaiah, born October 24, 2004, that philosophy has made all the difference.
“I’m going to breastfeed as long as I can — at least a year or two, or until he wants to stop,” says Torre. “He was early, and I want to make sure he’s healthy.”
Torre took advantage of the hospital Family Birth Center’s prenatal childbirth program and breastfeeding education opportunities. She made plans to breastfeed when the baby was born. She’d heard that it was healthier, that babies get fewer ear infections, and that it’s cheaper, too.
But when Isaiah came a month early, he was cared for in the nursery for several days because he couldn’t breathe well on his own and nursing him was difficult. He wasn’t able to eat much and had difficulty latching on to the breast. The nursing staff helped Torre learn how to pump her milk in the hospital until Isaiah was strong enough to eat on his own. And they eventually set her up with a “nipple shield,” which helps stimulate the sucking reflex in the premature baby.
“Breastfeeding is often a less likely choice for teenage mothers,” explains Trina Ammar, R.N., a board-certified lactation consultant and lactation service coordinator at the hospital. “But Jennifer began pumping within hours of delivery.”
Since going home, the only problem Torre has had with breastfeeding has been painfully enlarged breasts. The nurses at the hospital recommended that she get some cloth diapers, run them under warm water, and put them on her breasts for 10 to 20 minutes before feeding.
“That really helped,” Torre says. “I feel really close to him when I’m feeding. I’d really recommend it to
anybody.”
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