We have been using this core measure for about 1 year.We have 750 deliveries/year. We have a level 1 nursery--so mostly healthy term or near term babies at our hospital. JHACOs definition of what qualifies as exclusive breastfeeding may seem a little strict, and makes our exclusive breastfeeding numbers significantly lower, but I actually think this is a good thing.  It is making our hospital pay more attention to why our babies are getting formula.  Weight loss,hyperbilirubinemia, and low blood glucose may seem like legitimate reasons for supplementing, but much of the time the cause is poor breastfeeding management. We all know that in many cases these medical issues can be prevented to begin with.  It is my understanding that multiples, nursery/NICU babies, maternal medications, mother in ICU can all be excluded from the total births. Anyway, it seems to be working well for us. I calculate the statistics once per month.

Christine Lichte, BS, IBCLC
Warrensburg, MO

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