Maternal and Child Health Journal

, Volume 17, Issue 9, pp 1712–1717

Engaging Chicago Hospitals in the Baby-Friendly Hospital Initiative

  • Samantha L. Schoenfelder
  • Sadie Wych
  • Catherine A. Willows
  • Joseph Harrington
  • Katherine Kaufer Christoffel
  • Adam B. Becker
Notes from the Field


Breastfeeding is now widely recognized as a vital obesity prevention strategy and hospitals play a primary role in promoting, supporting and helping mothers to initiate and maintain breastfeeding. The Baby-Friendly Hospital Initiative (BFHI) provides an evidence-based model that hospitals can use to plan and implement breastfeeding quality improvement (QI) projects. Funding under Communities Putting Prevention to Work (CPPW), administered by the CDC, brought together key Chicago partners to provide individualized support and technical assistance with breastfeeding QI projects to the 19 maternity hospitals in Chicago. A community organizing approach was taken to mobilize hospital interest in breastfeeding QI projects, leading to successes, e.g. 12/19 (63 %) Chicago hospitals registered with Baby-Friendly USA, Inc. (BFUSA) to pursue official Baby-Friendly designation. Key factors that fostered this success included: involving all levels of hospital staff, financial incentives, and ongoing tailored technical assistance. To assist other communities in similar work, this article discusses the approach the project took to mobilize hospitals to improve breastfeeding support practices based on the BFHI, as well as successes and lessons learned.


Breastfeeding Baby-Friendly CPPW Quality improvement Community organizing 



Baby-Friendly Hospital Initiative


Baby-Friendly USA, Inc


Chicago Department of Public Health


Certified Lactation Counselor


Certified Lactation Specialist


Consortium to Lower Obesity in Chicago Children


Communities Putting Prevention to Work


Hospital Breastfeeding Council of Metro Chicago


HealthConnect One


Illinois Chapter, American Academy of Pediatrics


Illinois Department of Public Health


Multi-disciplinary committee


Quality improvement


Strategic planning committee


Technical assistance


  1. 1.
    American Academy of Pediatrics, Section on Breastfeeding. (2012). Policy statement: Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841.CrossRefGoogle Scholar
  2. 2.
    American Academy of Family Physicians. (2008). Breastfeeding, family physicians supporting (Position paper). Available at: Accessed 1 Feb 2012.
  3. 3.
    Association of Women’s Health, Obstetric, and Neonatal Nurses. (2007). Breastfeeding: Position statement. Available at: Accessed 1 Feb 2012.
  4. 4.
    Ip, S., Chung, M., Raman, G., Chew, P., Magula, N., DeVine, D., Trikalinos, T., Lau, J. (2007). Breastfeeding and maternal and infant health outcomes in developed countries. Evidence Report/Technology Assessment No. 153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No. 290-02-0022). AHRQ Publication No. 07-E007. Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
  5. 5.
    Arenz, S., Rückerl, R., Koletzko, B., & von Kries, R. (2004). Breast-feeding and childhood obesity—a systematic review. International Journal of Obesity and Related Metabolic Disorders, 28(10), 1247–1256.PubMedCrossRefGoogle Scholar
  6. 6.
    U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2012). Healthy People 2020. Washington, DC. Available at: Accessed 6 June 2012.
  7. 7.
    U.S. Department of Health and Human Services. (2011). Centers for disease control and prevention breastfeeding report card—United States, 2011. Available at: Accessed 23 Feb 2012.
  8. 8.
    U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2011). Breastfeeding among U.S. children born 2000–2008, CDC National Immunization Survey. Available at: Accessed 6 June 2012.
  9. 9.
    Baby-Friendly USA, Inc. (2012). BFHI USA. US baby-friendly birth facilities. Available at: Accessed 7 June 2012.
  10. 10.
    Kramer, M. S., Chalmers, B., Hodnett, E. D., Sevkovskaya, Z., Dzikovich, I., Shapiro, S., et al. (2001). Promotion of breastfeeding intervention trial (PROBIT): A randomized trial in the Republic of Belarus. JAMA, 285(4), 413–420.PubMedCrossRefGoogle Scholar
  11. 11.
    Merewood, A., Mehta, S. D., Chamberlain, L. B., Philipp, B., & Bauchner, H. (2005). Breastfeeding rates in US baby-friendly hospitals: Results of a national survey. Pediatrics, 116(3), 628–634.PubMedCrossRefGoogle Scholar
  12. 12.
    Baby-Friendly USA, Inc. (2010). BFHI USA. The ten steps to successful breastfeeding. Available at Accessed 9 June 2011.
  13. 13.
    Phillip, B. L., Merewood, A., Miller, L. W., Chawla, N., Murphy-Smith, M. M., Gomes, J. S., et al. (2001). Baby-friendly hospital initiative improves breastfeeding initiation rates in a US hospital setting. Pediatrics, 108(3), 677–681.CrossRefGoogle Scholar
  14. 14.
    Baby-Friendly USA, Inc. (2012). BFHI USA. Info for hospitals and birth centers. Available at: Accessed 5 June 2012.
  15. 15.
    Centers for Disease Control and Prevention. (2012). Communities putting prevention to work. Available at: Accessed 4 May 2012.
  16. 16.
    Longjohn, M.M. (2004). Chicago project uses ecological approach to obesity prevention. Pediatric Annals, 33(1), 55–57, 62–63.Google Scholar
  17. 17.
    Becker, A. B., Longjohn, M. M., & Christoffel, K. K. (2008). Taking on obesity in a big city: Consortium to lower obesity in Chicago children (CLOCC). Progress in Pediatric Cardiology, 25, 199–206.CrossRefGoogle Scholar
  18. 18.
    Becker, A.B., Christoffel, K.K., Morales, M.A., Rodriguez J.L., Lopez, J., Longjohn, M. (2011). Combatting childhood obesity through a neighborhood coalition. In Whitman, S., Shah, A.M., Benjamins, M.R., (Eds.), Urban Health, Oxford; 171–196.Google Scholar
  19. 19.
    Becker, A.B., Christoffel, K.K., Lopez, J.E., Rodriguez, J.L. (2012). Community Organizing for Obesity Prevention in Humboldt Park, Chicago: The challenges and successes of coalition building across two organizing traditions. In Mikler, M., (Ed.), Community Organizing and Community Building for Health and Welfare. Rutgers University Press; (in press).Google Scholar
  20. 20.
    Chicago Department of Public Health. (2012). Breastfeeding and the Baby-Friendly Hospital Initiative. Available at: Accessed 5 June 2012.
  21. 21.
    Illinois Chapter of the American Academy of Pediatrics, Illinois Academy of Family Physicians, and the Illinois Section of the American Congress of Obstetricians and Gynecologists. (2011). Available at: Accessed 15 June 2012.

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Samantha L. Schoenfelder
    • 1
  • Sadie Wych
    • 2
  • Catherine A. Willows
    • 3
  • Joseph Harrington
    • 4
  • Katherine Kaufer Christoffel
    • 5
  • Adam B. Becker
    • 1
  1. 1.Consortium to Lower Obesity in Chicago Children (CLOCC)Ann & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA
  2. 2.HealthConnect OneChicagoUSA
  3. 3.Obesity Prevention InitiativesIllinois Chapter, American Academy of Pediatrics (ICAAP)ChicagoUSA
  4. 4.Chicago Department of Public HealthChicagoUSA
  5. 5.Feinberg School of MedicineNorthwestern UniversityChicagoUSA

Personalised recommendations