Step by Step


Keystone 10 Module 5: Birth practices & breastfeeding





Credit Hours: CME 1.00

Target Audience:

Physicians, nurses, and other health care professionals who provide prenatal care, inpatient maternity care, and postpartum care.

Educational Objectives:

At the completion of this module participants will be able to:

  1. Identify hospital birth policies and procedures that support exclusive breastfeeding.
  2. Describe the impact labor events have on breastfeeding.
  3. Communicate to patients the benefits of early and uninterrupted, safe skin-to-skin contact during the first hour post birth.
  4. Exhibit the ability to help initiate breastfeeding by observing feeding cues.
  5. Recall strategies to support breastfeeding after a Cesarean birth.

The Curriculum in Support of Keystone 10: The Ten Steps to Successful Breastfeeding A 15 Hour Interdisciplinary Breastfeeding Management Course & Suggested Additional Reading:

These instructional modules were developed in collaboration between the Pennsylvania Keystone 10 Quality improvement Project and Johns Hopkins School of Nursing. They are intended to provide education which prepares hospital maternity staff to create an environment that is aligned to advance to 10 steps to successful breastfeeding and to meet the Keystone 10.

Running times for each of the 15 training modules vary, however total time for each module is 60 minutes in length. With completion of pre- and post-tests, this training meets the 15 hour didactic requirement of Keystone 10. Staff will still need to complete their competencies at their own site. Hospital staff can either complete the modules online here or can work with their hospital administrators to offer them for continuing education credits. In addition Keystone 10 offers face to face trainings and also trains trainers. For more information please email Dottie Schell at

Suggested Additional Reading & Joint Accrediation Statement:

Dozier, A., Howard, C., Brownell, E., Wissler, R., Glantz, J., Ternullo, S., & ... Lawrence, R.   (2013). Labor Epidural Anesthesia, Obstetric Factors and Breastfeeding Cessation.  Maternal & Child Health Journal, 17(4), 689-698. doi:10.1007/s10995-012-1045-4.

A Department of Health data:

Joint Sponsor Statement - Note: This Accreditation Statement Supersedes All Other Statements:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Pittsburgh School of Medicine and Pennsylvania Chapter American Academy of Pediatrics. The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credits'. Each physician should only claim credit commensurate with the extent of their participation in the activity.

Other health care professionals are awarded .10 continuing education units (CEUs), which are equal to 1.0 contact hours. Faculty for this activity have been requested to identify significant financial or other relationships with manufacturer(s) of any commercial product(s) or with provider(s) of any commercial service(s) which might affect the balance of their presentation.

Beverly Ann Curtis, DNP, PPCNP-BC, IBCLC, Pediatric Nurse Practitioner — Facilitator and Consultant for the Pennsylvania AAP and PA DOH Keystone 10 Initiative. Pediatric Nurse Practitioner at Keystone Pediatrics, Chambersburg Pennsylvania. Director, Outpatient Keystone Breastfeeding Center.
No relationships with industry relevant to the content of this educational activity have been disclosed.
No other members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

The University of Pittsburgh is an affirmative action, equal opportunity institution.