Trends in Breastfeeding Interventions, Skin-to-Skin Care, and Sudden Infant Death in the First 6 Days after Birth

Melissa Bartick, MD, MSc, FABM1,,Mary Ellen Boisvert, MSN, CLC, CLE2,∗, Barbara L. Philipp, MD, FAAP, FABM3Lori Feldman-Winter, MD, MPH, FAAP, FABM4

Baby-Friendly Collaborative Related Resources

Breastfeeding training online

Maryland Department of Health and Mental Hygiene (taught by fellows of the Academy of Breastfeeding Medicine), 6 hours of free CME (Verity Livingstone, MD, Vancouver, BC, Canada)

Breastfeeding Training from University of Virginia and Va Dept. of Health 20 CE credits at

Wellstart International (founded by the late Audrey Naylor, MD, DrPH)

Bella Breastfeeding– Provider Training is a peer-reviewed online course on OPENPediatrics, a free web-based learning platform designed for health care professionals. The purpose of this course is to fulfill the 3 hr requirement for provider education (Physicians, CNM, PA, APRN) as outlined in the Baby-Friendly USA Guideline and Evaluation Criteria manual.  CME pending. Go to, register, then search for “breastfeeding” or “bella.” Created by Massachusetts’ own Dr. Bobbi Philipp and Mary Foley.

General resources:

The Baby-Friendly Hospital Initiative: US website, with info and resources

Massachusetts Department of Public Health: Includes training and multiple links:

CDC website: For data and statistics, publications, such as Infant Feeding Practices Survey and National Immunization survey, and other resources such as:

CDC’s healthcare resources: such as crib cards and mPINC survey

Academy of Breastfeeding Medicine has multiple evidence based clinical protocols for topics such as supplementation, jaundice, hypoglycemia, as well as model hospital policies and discharge planning, includes their Model Maternity Policy Supportive of Breastfeeding (2018)

Communities and Hospitals Advancing Maternity Practices  (CHAMPS) , a collaborative advancing the number of Baby-Friendly hospitals across the Southeast and elsewhere. CHAMPS has a wWednesday webinar series from 12-1 Eastern once a month.This series discusses topics designed to help hospitals make changes needed to implement Baby-Friendly (eg, Skin-to-Skin, Staff Education, Rooming-In). Archived webinars available, too. From  CHAMPS

NICHQ’s Best Fed Beginnings is a nationwide quality improvement initiative to help hospitals improve maternity care and increase the number of “Baby-Friendly”-designated hospitals in the United States.

United States Breastfeeding Committee (USBC). Includes a toolkit and links for the Joint Commission Perinatal Care Core Measure Set and includes Core Competencies for all health care professionals

The Institute for Healthcare Improvement has a number of resources for supporting healthcare quality improvement efforts: There are Quick Links for the IHI Open School which includes essential training and tools in an online, educational community to help you and your team deliver excellent, safe care; there is also a helpful Improvement Map for guidance.

The Institute for Healthcare Improvement’s Plan-Do-Study-Act (PDSA) Worksheet is a useful tool for documentation in quality improvement efforts.

American Academy of Pediatrics (AAP) policy revision “Breastfeeding and the Use of Human Milk”. Discusses the current statement updates the evidence for this conclusion and serves as a basis for AAP publications that detail breastfeeding management and infant nutrition.

American Academy of Pediatrics (AAP Guideline for Safe Sleep in the Hospital and Newborn Period, Update 2016

The American College of Obstetricians and gynecologists (ACOG) has an informational breastfeeding page with resources, webinars, and clinical guidelines.

The American College of Obstetricians and gynecologists (ACOG) presents recommendations for breastfeeding care in “Optimizing Breastfeeding Support as Part of Obstetric Practice”

The American College of Obstetricians and gynecologists (ACOG) Breastfeeding Toolkit

American Academy of Family Physicians(AAFP)Position Paper “Breastfeeding, Family Physicians Supporting” (2015)

American Academy of Family Physicians(AAFP)Breastfeeding Toolkit (2015)

Stanford University Newborn Nursery resources which include multiple demonstration videos including hand expression, a perfect latch, info on frenotomy, and a diverse array of clinical guidelines

UCSF Newborn Weight loss Calculator (NEWT) – Unique and tool that tells you what is common and normal for exclusively breastfed infants by hour of life for vaginal and cesarean births, released in 2015.

Informational and fun videos:

The Warm Chain (YouTube) 9:46

The Baby-Friendly Rap (YouTube) 3:42

Teach Me How to Breastfeed (YouTube 3:00)

Resources from Massachusetts and Collaborative members

Hypoglycemia protocol example (Anna Jaques Hospital)

Massachusetts Department of Public Health Breastfeeding Page includes breastfeeding resources, breastfeeding toolkit, model hospital policies, and tools for 10 steps of Baby-Friendly Hospital Initiative

Formula Pricing Tool for calculating Fair Market Price of formula– From Mass. DPH and Northeastern University-LINK does not open on my computer (opens as download)

Exclusive Breastmilk Feeding Data Collection Tool v2 May 2014 –Downloadable file (see collaborative page)

Download Tobey’s “Skin to Skin Zone” sign

Resources from Brigham and Women’s Hospital on family centered care and skin to skin during c-sections. -–Downloadable file (see collaborative page)

Breastfeeding logs in 4 languages– English, Spanish, Brazilian Portuguese and Haitian Creole from Cambridge Health Alliance- –Downloadable file (see collaborative page)

Cambridge Health Alliance (CHA) Weight Loss Guideline -Since changing its weight loss and supplementation guideline in 2013, CHA has been able to markedly reduce supplementation rates

Melrose Wakefield tools for exclusivity: Educational checklist and handout/poster for parents

Downloadable file 

Formula vs Breastmilk microscopic photo (from Bobbi Philipp/Boston Medical Center) – Downloadable file 

Supplementation and breastfeeding exclusivity QI Slides from Northeastern; from Baby Friendly Collaborative meeting January, 9 2014 (Edward/Boisvert) – Downloadable file 

Massachusetts NeoQIC Collaborative Information on breastfeeding for parents of preemies available in 8 languages