A mother starts connecting with her baby the moment she finds out she is expecting. From the first time of meeting her baby on the sonogram, a mother starts dreaming of the day she will hold her baby near and commits herself to nothing but the best for them.

Research has established that there is no better source of nourishment for a newborn than breast milk. From its easily digestible composition to immunity loaded nutrients, breastfeeding not only benefits the baby’s health but has positive impacts on the mother’s health as well. Realizing that 820,000 children's lives could be saved if optimally breastfed within the first two years of life, the World Health Organization (WHO) and UNICEF established the Baby-Friendly Hospital Initiative (BFHI) in 1991. This scheme aims to motivate facilities that provide maternal and newborn services across the globe to strongly support breastfeeding. The baby-friendly accreditation is granted only when a facility is following the ten steps to successful breastfeeding strategy as proposed by WHO. Many health care organizations around the globe are in line with this vision and have been awarded this accreditation.

Cerner’s maternity solution

Cerner Millennium® is an integral part of health care providers’ caregiving processes, allowing clinicians to provide optimal maternity and child health services with the greatest efficiency. With breastfeeding support, the journey within Cerner Millennium starts before a baby is born. A hospital with a Cerner-built Health Information System (HIS) is equipped with the PowerChart Maternity™ solution, which covers the entire journey from the antenatal period up to delivery. Expecting mothers attending health centers are privileged to be followed by clinicians who have robust guidance through the system that is very much tailored to their needs during this phase. From identification of birth and feeding plan to suggested care and methods of lactation, Cerner Millennium becomes more than a HIS. Cerner helps create a guide for clinicians in a phase-by-phase approach and across trimesters of pregnancy depending on the needs of each step in this journey.

Patient education

During the antenatal phase, patient education is crucial. Many expectant mothers experience doubts about many aspects of their pregnancies and breastfeeding becomes a very much relevant topic towards the end of this phase. Throughout the antenatal visits, physicians and nurses interact with pregnant women and provide coaching and education related to lactation or breastfeeding among other topics. Cerner Millennium is equipped with a content-rich educational library at each clinician’s disposal during every phase of pregnancy.

Over time, it has been proven that right after birth, immediate skin-to-skin contact between mother and baby has many benefits for both. WHO and UNICEF have recommended the initiation of skin-to-skin contact and breastfeeding within the first hour of a baby’s life. Research has shown that babies whose breastfeeding was delayed beyond two hours after birth are at a 33% higher risk of dying within their first 28 days of life when compared to those who were breastfed immediately.

Recognizing this crucial step, Cerner Millennium has enabled physicians to add orders within PowerChart for nurses to initiate skin-to-skin contact within one hour of birth and set a fixed interval to the repetition of this process. This acts as a reminder to nurses in the labor suite and at the post-partum (after delivery) unit to start this process following rooming by, for example, allowing the baby to sleep in a crib near the mother in the same room for closer bonding and feeding at frequent intervals. The system provides nurses with the necessary tools to document these observations and conduct relevant assessments to the mother and child in addition to education on many aspects including:

• Newborn feeding methods and techniques
• Maternal breastfeeding assessment (quality, method, and breast exam)
• Benefits of exclusive breastfeeding and disadvantages of other types of feeding
• Overall baby feeding intake (intervals, amount, consistency, etc.)
• Observing for LATCH tool (related to proper breastfeeding quality)
• Breastfeeding assessment (time, frequency, comfort, and need for assistance)
• Lactation monitoring (encounter with lactation consultant before leaving the hospital with the baby)

Furthermore, the system has a range of baby feeding planning, history taking and education topics that not only focus on the baby’s feeding but rather cover the entire process including the mother’s comfort and wellbeing, newborn care, as well as proper techniques and protocols to provide optimum nutrition to the baby while having a good experience doing it. This not only serves as clinical decision support but also as a mechanism of capturing important information which can be defined as a key performance indicator (KPI). The KPIs help the caregivers understand how they are achieving their defined goal of breastfeeding within one hour of a child’s birth, hence improving patient outcomes.

The system has the capability to save and recall each documented education session, thus assisting the lactation consultants to follow up with mothers and newborns post-discharge. In addition to accessing the overall childbirth and feeding plan, the consultants can see the previously conducted education sessions, baby’s weight, mother check-ups, as well as the progress of events across all visits. This provides an overview of how new mothers and babies are progressing and focus on areas where new mothers may not be confident while building upon what was previously done. Specific educational material is available for clinicians, such as breastfeeding benefits, nutrition, and lactation, expressing and storing breast milk, self-care while breastfeeding and going back to work.

When mothers bring their babies for well-baby visits, all this information is available for care providers to review. Along with other assessments, they have tools to conduct a nutritional assessment and take appropriate action when required.

It can be a cumbersome journey for a new mother if left unsupported and it can have an impact on the baby’s health outcomes in the long run. Realizing the importance of breastfeeding, Cerner works hand-in-hand with our clients and strives to implement key measures that help create a complete mother-and-baby-friendly experience within many of our clients’ facilities to deliver a world-class health system for a healthier population.