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Staff Training for Baby-Friendly: How to Choose a Course for Step 2

Healthcare workers preparing for staff training for Baby-Friendly.

Maybe you’ve already started your journey to becoming Baby-Friendly. You might be wondering how to provide staff training for Baby-FriendlyStep 2 specifies that the facility must “[t]rain all health care staff in the skills necessary to implement [its breastfeeding] policy.” But how do you go about that?

Here are the 3 questions I hear most frequently from hospital administrators:

  • What course meets the criteria?
  • How can we check-off the step as “done”?
  • What’s the lowest possible price?

In a way, this all makes sense. Good administrators keep one eye on meeting requirements and the other on the bottom-line!

For sure, you must pay the bill. And when staff training for Baby-Friendly has been completed, check the box. That’s necessary, but not sufficient, to fulfill Step 2. But remember something. Staff training for Baby-Friendly must enable staff to implement the policy. I repeat: implement. That means it must provide more than just “head-knowledge.”

Never once has someone asked me, “Will this training help my staff to implement what they’ve been taught?

Yet, it’s critical that staff have good skills. They need communication skills, teaching skills, problem-solving skills, and some specific psychomotor skills. How can you be sure your staff develop these as you fulfill Step 2?

As you consider your Baby-Friendly staff training options, keep these ideas in mind:

The course does not and cannot have “Baby-Friendly” in the title

You might assume that a course with “Baby-Friendly” in the title signifies that it fulfills Step 2 requirements. However, no credible program will have “Baby-Friendly” in its title. That’s because Baby-Friendly USA controls use of the term “Baby-Friendly.” It allows “Baby-Friendly” only for recognizing birthing centers and health centers that meet its criteria — NOT for courses, educators, training programs, or others. No course can rightly use the term in its title.

The course must cover all topics identified by the World Health Organization

For maternity staff, training must cover Steps 3 through 10. It must include the topics and subtopics of all sessions identified by the World Health Organization. Reputable course directors will have these 15 sessions laid out, and ready to deliver.

Look for staff training for Baby-Friendly that emphasizes “doing” rather than “knowing.” Remember, Step 2 requires the implementation of these 10 best practices, not just knowledge of them.

The course should have credible faculty

If you’re like me, you think carefully before choosing any course. Whether I’m buying a course for my licensure or credential, or a software course for my staff, I ask myself these questions:

  • Will this meet the learner’s needs?
  • Does the instructor present the information so it will be understood and implemented?
  • Will this be worth what I paid for it?

It can be hard to discern the exact nature of a course from its description alone. A good first step is to review faculty credentials. Personally, I also rely on my past experience to help. Take a look at their licensure and certificates, experience, and areas of expertise. Look for reviews or testimonials from past clients. Want to know more? Call their office, or send an e-mail. Choose someone with experience and knowledge you trust.

Sometimes, the written description is limited. Don’t hesitate to call and find out more about the course or the instructor. Calling gives you a chance to familiarize yourself with the people behind the product. Don’t commit thousands of dollars for something or someone who seems to lack credibility.

The course should have generally-acceptable design elements

As a learner, I rarely see meaningful learning objectives in course descriptions. Most say “discuss,” “describe,” or “identify.” But even before I take a course on a topic, I can usually discuss, describe, or identify it. So what will I learn? Those objectives tell me what I’ll be expected to know. But they don’t give me a clue about how the course will help me to do better. Hence, written objectives may have limited value when choosing a course.

However, if you see a course without any written objectives at all, skip it. Any reputable course should have stated objectives. It should have several other educational design elements, too. These include goals, teaching methods, content, a bibliography with the highest levels of evidence available, and an evaluation mechanism. Ideally, there should be some way for the learner to ask questions and get feedback.

Must you provide an accredited course in order to fulfill the Step 2 requirements? As a continuing education provider, how I wish this was true! I work hard to offer courses that are approved by various accreditation agencies, but sadly, no, this is not required for staff training for Baby-Friendly.

The course should be user-friendly for staff

You probably have your own definition of “user-friendly,” which may differ from that of training participants. The bottom line? They might even consider it user unfriendly.

Nevertheless, you and your staff are likely to agree on some user-friendly features. These would include clear instructions, good handouts and/or outlines, and the ability to easily review instruction.

The course should be user-friendly for administrators

Administrators, not “using” the course themselves, don’t look for a user-friendly component for administrators, managers or supervisors — but they should!

When I was responsible for training 250 nurses in a tertiary care hospital, I was substantially overwhelmed. Who has started? Who’s started but not finished? Who finished but didn’t get a certificate? What about the newly-hired staff; did they even sign up? What about someone who claims to have completed the program but lost their certificate?

I design my course outcomes to overcome administrative headaches related to staff progress and completion. For example, we provide a continuously updated automated roster of participants to the supervisor. It can be easily handed to the assessors during assessment for Baby-Friendly recognition. Also, attendees can generate and print their own certificates.

Staff training for Baby-Friendly should aim to improve practice

This is the linchpin, isn’t it? Yet, how are you going to know if the course really accomplishes this?

Mandatory education merely insists that attendees sit in the seats. It does not “force” them to learn, or to change their clinical behaviors. All of this is related to affective objectives — basically, changing learner attitudes. (This topic has received relatively little attention in the education literature, compared to cognitive and psychomotor objectives.)

I’ve spent more than 25 years teaching literally thousands of nurses all across the U.S. Luckily, I’ve had many motivated course participants. But whether or not the learner is motivated, I focus more on teaching methods rather than attitudes. Active learning strategies for any endeavor are the best way to combat intellectual inertia.

Be an informed consumer of what you are buying

Staff training for Baby-Friendly Step 2 must consider the financial bottom-line. But there are some variables to consider. Ask questions about the course you are considering. Did you get a per-person or per-unit quote for the cost? How many, and what kinds of employees, will attend the staff training? Can you identify any hidden costs?

In addition to the price of the training itself, what will it cost to pay staff for their time doing the training? Will it be effective? If ineffective training results in lack of skills, the assessors are likely to notice that. That’s not an expense you want to incur.

Leave me a note in the comments section below, or call my office, for more details.

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  1. Lisa

    Hi Marie,
    At the hospital in which I am the Lactation Coordinator we have created our own 20 hour class. We used the healthy children class and WHO for references. Our class consists of an 8 hour class day, a online module that takes about 4 hours to complete, and 8-12 hours with an IBCLC in the clinical setting for the nurse to demonstrate her skills. If more time is needed with an IBCLC it is granted. For all brand new nurses to the unit they get 2-3 days with an IBCLC. It’s challemging getting everyone through, we have 80 nurses and I’m the only IBCLC. We are also having the OB APP’s and PNP’s attend the class and have clinical time. Just wondering if this plan sounds ok? I teach the class once a month and I have 2 staff at a time shadow with me every Monday and Tuesday.

  2. Marie

    Hmmmm. It’s tough to say, Lisa. When you ask if the plan sounds okay, my gut reaction is to ask…okay for what, exactly? If you’re asking if it is adequate to fulfill your Step 2 requirement, I’d say–yes. Presuming that you have all of the details in place, it seems like it would indeed fulfill your requirement. But my point in the blog was, it’s about more than checking the box. There are a couple of things that jump out at me in your description.

    First, do you have an evaluation mechanism in place? A “test” is a common way, but not the only way to evaluate education. Without some sort of evaluation mechanism, you come to…

    Second, how will you know if the training gets implemented? This is related to, but separate from, evaluation of what might be “head knowledge” or short-term knowledge. But on a daily basis, is the staff living what they’ve learned?

    Third, I’ve been teaching registered nurses in one capacity or another for more than 25 years. I am not a fan of “shadowing.” In my experience, shadowing has limited value. I’d suggest you find a way to make sure that such “shadowing” has some structure, and some way to know if it works.

    Great question, thanks for the giving me the opportunity to sound off on one of my favorite topics. If I were queen for a day, I would totally re-do how staff training for RNs works in the US. But that’s a story for another day!

  3. Joann Parker

    I’m trying to find the link to list the required staff competencies, this is what I found: 1. Infant positioning at Breast, 2. Infant Attatchment at breast 3. Observation of a breastfeed. 4. Hand expression of breast milk. & 5. Breast Massage and reverse pressure softening. Is this current ? Is there something I missed? Thank You ,
    Joann Parker RN

    • Marie Biancuzzo

      Joann, I read your comment twice, but I’m unclear about your question. The post was about Step 2 (train all staff.) So are you wanting to know where to find the “official” competencies in order to meet the criteria for meeting Step 2 at your hospital?

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