“It’s a journey,” shares nurse Carole Swain as she talks about Natividad Medical Center’s efforts to become a Baby-Friendly hospital. Swain initiated the journey more than 20 years ago when the World Health Organization (WHO) and UNICEF published a landmark declaration in support of breastfeeding.

“My big thing is the health of the community,” continues Swain. “Breastfeeding is the first step to healthy children, and the beginning of a lifetime of healthy eating.”

Swain and her colleagues at Natividad Medical Center have been following the 10 steps outlined by WHO and UNICEF to become a Baby-Friendly hospital that encourages and supports breastfeeding.

Natividad Medical Center is located in the Salinas Valley of California, the center of Monterey County’s $3.8 billion vegetable and fruit industry, where more than 70,000 people work in the fields. One of 17 safety-net hospitals in the state, Natividad Medical Center provides essential hospital services to 80 percent of the community’s uninsured and underinsured.

Community health and equity are drivers of change

“Obesity, diabetes, high blood pressure are huge issues in our community,” says Judith Lavoie, director (now retired) of Women’s and Children’s Services at Natividad Medical Center. “Our journey to become Baby-Friendly is about community health and equity.”

The Natividad Medical Center serves a unique patient population, with a large proportion of migrant farm workers and immigrants who speak limited English. More than 22 languages are spoken, which creates communication barriers. Additional challenges include overcoming women’s misconceptions that their breast milk will sour while working under the hot sun or that their colostrum (the thick substance that mothers produce initially) isn’t adequate nutrition for their babies.

“It was an ethical, moral and financial commitment to become Baby-Friendly,” says Linda Ford, CEO of Natividad Medical Foundation. Part of the financial commitment was the medical center no longer accepts infant formula donations, which equaled about $20,000 a year.

“This is what it’s all about,” shares Rosa Gutierrez, while holding up a picture of her grandson. A nurse who had her children at the hospital and whose grandchildren have since been born there, Gutierrez talks about breastfeeding as multi-generational. “I’m passionate about breastfeeding because of all the benefits to the newborn, as well as to the mother.”

Making a cultural shift

The journey to becoming a Baby-Friendly hospital has included adopting new policy and training healthcare staff. “It required changing physician’s mentality from wanting to take a baby away from its mother right after birth to allowing immediate skin-to-skin contact,” says Judith Lavoie. “We call it the golden hour.”

The Natividad Medical Center invested in extensive staff training, teaching physicians and nurses about the importance of breastfeeding and ways to support mothers in initiating and sustaining breastfeeding.

“Since our ‘Breastfeeding is the Best Feeding’ campaign to educate all the medical staff, there’s been a great relaxation around breastfeeding,” reflects Lavoie. “It’s become much more of a norm.”

The Medical Center also practices “rooming-in,” so that mothers and newborns can stay together, and provides comprehensive lactation support to mothers and families. Additionally, it created patient education materials tailored to address specific breastfeeding concerns of the community they serve.

“Since starting down the path to Baby-Friendly, family is at the center of all we do,” says Dr. Kathryn Rios. “We are much more family oriented.” The celebration of families and breastfeeding is evidenced in the large photographs of mothers, fathers and babies that line the hospital walls.

“We need to think bigger than what’s good for the hospital, we need to think what’s good for the community,” says Lavoie.

“Any hospital that can become Baby-Friendly, should become Baby-Friendly,” encourages Dr. Rios. “This is going to make a healthier population.”

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