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Maternity facilities that follow the 10 steps of the Baby-Friendly Hospital Initiative have improved breastfeeding outcomes. Prior to the DC Breastfeeding-Friendly Hospital Initiative, no maternity facilities in Washington, DC, were recognized as Baby-Friendly. Each facility's journey toward improved breastfeeding support is unique. The purpose of this project was to help facilities identify areas to focus on in pursuit of this goal. All 8 birthing facilities in Washington, DC, participated in the baseline assessment in September 2008. The 10 steps were used as a framework for developing the assessment tools. Data were collected from each facility regarding (1) accessibility of breastfeeding information and resources on its website, (2) content of written breastfeeding policies, and (3) practices that support breastfeeding. The DC Breastfeeding Coalition shared the outcomes of the assessment with each facility and offered an educational session addressing each facility's specific needs. The coalition also conducted postintervention evaluations between July and August 2009 to assess changes in each facility's score. Most facilities were receptive to the intervention, resulting in modest improvements in all areas reviewed. This project provides a model for state and local breastfeeding coalitions to evaluate and recognize incremental improvements in breastfeeding-related maternity care practices.

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