Okay, here's what I've learned about researching training materials for the BFHI project so far. Correct me if I'm wrong, but this is what I've been able to find out thus far. 
The Birth & Beyond project was originally development by the California Department of Health and it was based largely on breastfeeding curriculum developed by the World Health Organization for the BFHI project. The breastfeeding research, education and training for healthcare staff recommendation that have been developed by WHO and UNICEF over the past 40 years are really the best that we have as far as research and breastfeeding recommendations worldwide at this time, I think. It is what the Baby Friendly hospital recommendations are based on. WHO developed at 20 hour training program that can be freely accessed by anyone in the world. However, the training manual is about 300 pages long and can be difficult for staff to work through. But I would recommend that anyone who is taking on the task of training hospital staff consider reading through it first because it will give you a good overview of what BFHI recommendations are and this is ultimately the information that you are responsible for knowing and teaching to staff. Taking on the task of educating your staff is an enormous project, but I found it was so beneficial for me as well. I learned so much by reading through these materials and teaching them to others. It really helped all of us get on the same page with our information. Here is the WHO link. Best case scenario is that all RN's and LC's on a maternity unit complete the training so everyone is in agreement with information. 
http://www.who.int/nutrition/publications/infantfeeding/bfhi_trainingcourse/en/


Around 2005, the California Dept of Health took these training materials and developed the Birth & Beyond project which met most of the standards for Baby Friendly hospital designation (but not all). It covered about 16 hours of training and it was in a powerpoint format which is a little better for staff training. It also includes many other materials that you might find helpful. They have a presentation to give to hospital administration to get them on board with the BFHI project that I think is very good too. What happened was that the state of california decided that this should be a healthcare initiative statewide so they developed this curriculum and offered training for free for any hospital in the state of california to send their nurses to for free to try to increase breastfeeding rates. As a result there are more BFHI hospitals in CA than in any other state and they had a big increase in breastfeeding rates, I believe. It included most of the BFHI elements but not all and was about 16 hours of education, I think. Here's the link:

http://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Pages/BirthandBeyondCaliforniaDescription.aspx

Then in 2012 (updated in 2014), the Vermont Department of Health took this project and developed it into a beautiful picture/Powerpoint training program that provides most of the required elements for BFHI certification, plus an optional separate section that includes all of the remaining elements required by BFHI, and it also includes a lot of other supplemental materials too. It's really nice here is the link. Scroll down to the bottom of this link and you will see where you can access the materials with the username and password. 

http://healthvermont.gov/wic/food-feeding/breastfeeding/10steps/

It's not the usual powerpoint format though, just to forewarn you. It's largely pictures with very few words on the screen. That is because they found that it increases the learner's retention not to try reading words on the screen, reading their notes and listening to the speaker at the same time. That can be information overload and reduce retention. Our staff loved the beautiful pictures and presentation and it did make it easier for them to retain the main ideas, I think. They will make the password available to anyone who asks. You just need to email the administrator and she will send it to you. Here is her email:

[log in to unmask]

We used them to provide staff training for our RN's in our maternity unit at a hospital just outside of Chicago, IL. We did 1,200
deliveries last year and we saw an immediate increase in breastfeeding initiation and duration. I believe that the heart of the BFHI is the idea that what breastfeeding mothers really need is access to healthcare providers that are truly educated about breastfeeding. There are no shortcuts. They need to be adequately trained or things will never get better for breastfeeding women. Not only that, but I think in large part due to the quality of education they received, it made it much, much easier for us to get policies passed for delayed bathing of the newborn for 24 hours after delivery, all routine procedures done on the newborns are now done in the parents room, and skin-to-skin contact during cesarean sections. None of that would have happened without the nurses understanding how and why they are physical and psychologically beneficial to the parents and newborns.

There are many hospitals that simply purchase an online program for their staff training. However, my experience is that these programs really don't work as well because most staff won't read them or retain the information unless they are highly motivated. In order to make changes we need to work to provide education that changes attitudes and practices and this is a long process with no shortcuts, I believe. I find that many administrators and managers who will agree to education for staff about breastfeeding will immediately say, okay how can we do it so it's the cheapest and fastest. But they should be saying how can we do it so it's the best and actually works. If your staff do not read or retain an online program you are still going to be fighting an uphill battle. Actually, I was just reading the CDC's breastfeeding recommendations and they said that 2 studies have shown that online programs for physicians did not result in increases in breastfeeding initiation and duration and I would agree. That is what I've seen too. But that more comprehensive education, such as going for a CLC designation did result in increases in breastfeeding rates. It just makes sense to me. When it comes to education, go for quality, not quantity.
Good luck,

Tricia Shamblin, RN, IBCLC

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