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Booby Traps Series: Big hospitals to be evaluated on exclusive breastfeeding rates by the Joint Commission | Best for BabesBest for Babes

Booby Traps Series: Big hospitals to be evaluated on exclusive breastfeeding rates by the Joint Commission

by Tanya Lieberman, IBCLC | December 11, 2012 6:22 am

This post is the 65th in a series on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

Here’s a big piece of news in the fight against Booby Traps:  The Joint Commission will now require larger hospitals to use exclusive breastfeeding as a core measure of performance.

Wait, wake up!  I know this news is a little boring-sounding, but it’s a big deal and I’ll try to make my explanation as colorful as possible.  Upcoming words include:  panic, fear, and topless.

The Joint Commission (formerly JCAHO) accredits and certifies thousands of hospitals.  A hospital that loses its accreditation can lose its state license to operate and ability to collect Medicaid reimbursement, so they inspire a lot of fear and panic among hospital staff.  As I wrote last year:

I’ve worked in two hospitals providing breastfeeding support, and I can tell you that no two words invoke more fear among hospital staff than “Joint Commission.”

I attended a training in advance of a Joint Commission visit, and one of the directions the hospital gave was (I’m not making this up), “If you see a Joint Commission representative do not run away.”

I did in fact run into two Joint Commission representatives when I was working in one hospital.  To the mild embarrassment of some half-topless moms, they walked into the outpatient breastfeeding clinic I was running, looking for information about post-discharge breastfeeding rates.  They had been impressed with the in-hospital rate (which is a little funny since in a community like mine initiation has a lot more to do with demographics than anything else, but I was happy that they were interested in breastfeeding at all) and wanted to know if the high rates persisted in the community.

But this line of questioning was strictly voluntary.  This was a number of years ago, and there was no requirement that they explore breastfeeding outcomes.

A few years ago the Joint Commission announced that exclusive breastfeeding would be a measure hospitals would be evaluated on – but this was voluntary.  Hospitals could choose to be evaluated on it or not.

On November 30th, the Commission announced that it would be mandating the use of exclusive breastfeeding as a measure in larger hospitals starting in 2014.

This, as the Massachusetts Breastfeeding Coalition points out, is quite significant, as “research from the Centers for Disease Control and Prevention has consistently shown that giving formula without a medical reason is one of the biggest predictors of early termination of breastfeeding.”  And because 4 out of 5 hospitals report that they supplement babies for no medical reason, this will give hospitals a powerful incentive to change their practices.

So, this is great news.  I hope it paves the way for the use of this measure at all hospitals.  And that’s something worth staying awake for, right?



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