We've been looking at these numbers for sometime.  The Joint Commission Tool Kit is very useful in understanding what is defined and counted as exclusive breastfeeding.  

So for example if I have 100 births this month
Out of my 100:
 40 are only fed breast milk.  
 20 are only bottle fed as per maternal choice
40 are fed both..however out of those 40- 4 are premature infants discharged from the nicu and 6 hypogycemic unrelieved by breastfeed.

So when calculating my stats on exclusivity it would be:

40/60-4-6 (as d/c from nicu and BGM unrelieved by bfing are allowable supplementation and can be "thrown out")
=80% exclusive rate.

Infant who are bottlefeeding need a MD order for formula as do infant who are supplemented.  When breastfed infants are supplemented it needs to be documented by the nurse why..medical supplementation or maternal request (after exclusive education was given hopefully)

I am blessed to work in a hospital with a computer system that has been customized by our CNS to cull those numbers.  Something we've worked on for the past few years.  Some of our examples are actually in the Joint Commission toolkit.

At least that's the way we do it.

Denise Bulpitt RN BSN IBCLC
ST. Vincent's Medical Center
Bridgeport, Ct. 06607

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