Q&A: Gillian Gonzaba, NNP-BC - Building Healthier Beginnings for the Tiniest Texans

There are critical gaps in the rates of breastfeeding and safe sleep practices among newborns in Texas. Breastfeeding is widely recognized as the most beneficial feeding method for infants, associated with reduced risks of infections, chronic conditions, and improved maternal health. Adherence to safe sleep practices is critical for reducing preventable sleep-related infant deaths, which disproportionately impact historically underserved populations in Texas. In 2019, sudden infant death syndrome (SIDS) was the fourth leading cause of infant mortality in the state, following congenital anomalies, prematurity, and complications of low birth weight.  Lactation and Safe Sleep Opportunities in Texas (LASSO-TX) is a new statewide quality improvement initiative (QI) focused on improving exclusive breastfeeding rates and the use of a mother’s own milk for Texas infants while promoting safe infant sleep best practices. LASSO-TX is modeled after the IHI Breakthrough Series Collaborative framework, which involves enrolled hospital collaborative learning and support as they work toward strengthening evidence-based care practices.

To support hospitals in their QI efforts, the Texas Collaborative for Healthy Mothers and Babies (TCHMB) will host three in-person learning sessions (February 2026, June 2026, and October 2026) with monthly action period calls in between. Hospitals will periodically submit de-identified aggregate-level data to track their progress and receive ongoing collaborative support, expert coaching, and technical assistance. As of August 2025, LASSO_TX hospital recruitment is underway.

Gillian Gonzaba, NNP-BC, a neonatal nurse practitioner and longtime partner in maternal-newborn quality improvement, sat down with me to highlight why the project matters.

1. What is LASSO-TX, and why is it important?

LASSO-TX is a unique opportunity for TCHMB to bring together maternal and newborn care teams across Texas. It’s [TCHMB’s] first opportunity to really partner across both maternal and neonatal care to improve the overall health of the mother-baby dyad. This effort is about making sure evidence-based standards show up in everyday practice. That takes more than just education and training; it requires a change in hospital culture and improving how systems work. Hospitals can lead the way by showing what good, evidence-based care looks like, partnering with families and building a supportive environment where all care teams work together.

We’re excited to begin this worthwhile pursuit of providing collaborative support to hospital improvement teams as they improve maternal and infant health outcomes across the state.

2. Why is this work particularly important in Texas?

Despite the well-established benefits breastfeeding provides for infants, not every baby born in the state of Texas is exclusively breastfed after birth. Texas also has several counties with the highest rates of sudden infant death syndrome (SIDS) and sudden unexpected infant death (SUID) in the United States. Hospitals are key to improving these outcomes by providing education and care that follows best practices.

Currently, the care families get can look different depending on the hospital. There are notable disparities in breastfeeding and safe infant sleep practices that persist across hospital settings and communities, especially among underserved populations. Our goal is to help support hospitals in removing systemwide processes and structural barriers to improve infant nutrition and care. We want families to get high-quality breastfeeding and safe infant sleep support, no matter the hospital.

3. What drew you personally to LASSO-TX?

Breastfeeding isn’t always natural or easy. Some moms and babies need extra support, and neonatal intensive care unit (NICU) nurses are called on every day to provide that help. When I first started as a NICU nurse, before becoming a nurse practitioner, I didn’t have any children of my own. That made it challenging to support moms who were learning to breastfeed. I called on my colleagues and friends who had nursed and watched lactation consultants with fascination.

We have some phenomenal lactation consultants across the state who are truly skilled at connecting with moms in ways that are unique to their craft. Later, once I became a mother myself, I was fortunate to achieve the breastfeeding goals I set for myself and my children, which deepened my understanding of how meaningful — and how hard — breastfeeding can be.

Many people think breastfeeding is a natural, automatic process: Just bring the baby close to the mom and they’ll know what to do. While that’s true for some babies, it isn’t for all. Some babies need extra help. Some moms need extra help. That’s where support makes a real difference.

Being part of LASSO-TX is an incredible opportunity to support hospitals in advancing care so they can better serve families and communities across the state. For me, it speaks to what about my work touches my heart: helping a mother form and nurture her unique bond with her baby. It’s unlike any other bond that exists because you’re giving your baby something created just for them exactly the right way every time.

I’m excited to support LASSO-TX and help expand breastfeeding and safe infant sleep supports across Texas.

4. How will you know if LASSO-TX is successful?

Success, to me, means hospitals have the resources to continue this work and build on their progress even after the initiative ends. The goal is for hospitals to develop the ability to effectively test, scale, and implement changes to achieve patient care objectives they set for themselves. We hope to lay a strong foundation by equipping hospital teams with the culture, education, and tools needed to keep moving forward.

It's not just about improving outcomes, though that’s important. We also want to give our partners quality improvement tools they can carry for LASSO-TX and any future projects. If we can do that, I believe we’ve succeeded.

Gillian Gonzaba, NNP-BC, is Co-Chair of the Texas Collaborative for Healthy Mothers and Babies (TCHMB) Neonatal Committee and a member of the TCHMB Executive Committee.

Women in Medicine Month

At the Texas Collaborative for Healthy Mothers and Babies (TCHMB), we are proud to use September (Women in Medicine Month) to recognize the outstanding women leaders driving our quality improvement (QI) efforts through their expertise, vision, and commitment to our Executive Committee and other workgroups and our internal staff. These women provide invaluable expertise and vision to drive our mission forward.

This Women in Medicine Month, we honor the women of TCHMB whose leadership and dedication are shaping perinatal QI efforts across our great state. Dr. Charleta Guillory, TCHMB chair, believes “The children of Texas need you — your voice, your passion, your vigor, your indomitable spirit.”

Their collective impact is reflected in the work of the remarkable women who serve on our Executive Committee and lead key initiatives across the state. As women medical leaders in Texas and nationwide, TCHMB women leaders in medicine advance health care quality and patient safety for all Texas mothers and babies.

Gloria Delgado, MSN, RNC-OB — Obstetrics Co-Chair, Executive Committee

Delgado serves as an Assistant Administrator of Women’s Services at University Medical Center of El Paso, overseeing labor and delivery, mother-baby care, and public health programs like Nurse Family Partnership. She brings extensive expertise in managing health care operations to ensure safe, high-quality care for mothers and babies.

Catherine Eppes, MD, MPH — Past Chair, Executive Committee

As Chief of Obstetrics at Ben Taub Hospital and a maternal-fetal medicine physician at Baylor College of Medicine, Eppes focuses on quality, safety, and infectious disease management in pregnancy. She has collaborated with the Centers of Disease Control and Prevention (CDC), American College of Obstetricians and Gynecologists (ACOG), and Texas Medical Association (TMA) on initiatives including Zika virus prevention and perinatal care improvement.

Jasmine Farrish, CNM, MSN, MPH — At-Large Member, Executive Committee

Farrish, a Certified Nurse Midwife at Los Barrios Unidos Community Clinic, began her career as a postpartum doula and now oversees home visiting and midwifery programs. She is committed to providing personalized, nonjudgmental care to support families across the Dallas area.

Kendra Folh, DNP, RNC-OB, C-ONQS, CPHQ, LSSBB — Data Co-Chair, Executive Committee

Folh is Program Director for Women’s and Children’s Services at Memorial Hermann Healthcare System. Drawing from her personal experience as a preterm birth survivor, she drives QI initiatives and collaborates nationally on perinatal safety to champion healthcare innovation for maternal and neonatal populations.

Alice Gong, MD — Vice Chair/Chair-Elect, Executive Committee

Gong is a Professor of Pediatrics at UT Health San Antonio and Medical Director of the PREMIEre program and the Mother-Baby Unit at University Hospital. She has spent decades advocating for newborns and families, advancing early neurodevelopmental care, and educating generations of clinicians through her research, publications, and presentations.

Gillian Gonzaba, NNPC — Neonatal Committee Co-Chair, Executive Committee

A Neonatal Nurse Practitioner and Associate Director for High Reliability/Patient Safety and Simulation at Pediatrix Medical Group, Gonzaba leads multidisciplinary teams focused on QI, patient safety, and neonatal care. She has extensive experience with simulation training and process improvement in neonatal medicine.

Charleta Guillory, MD, MPH, FAAP — Chair, Executive Committee

Guillory, Professor of Pediatrics at Baylor College of Medicine and Director of the Neonatal-Perinatal Public Health Program at Texas Children’s Hospital, has led efforts to reduce Black infant mortality and improve newborn care. Her leadership in policy and community initiatives has had a profound impact on maternal and infant health statewide.

Sonal Zambare, MD — At-Large Member, Executive Committee member

Zambare, Assistant Professor of Obstetric Anesthesiology at Baylor College of Medicine, brings expertise in anesthesia, analgesia, and critical care for mothers during birth and postpartum. She is actively involved in patient safety, education, and simulation programs, and she supports care for mothers with substance use disorders.

TCHMB also recognizes the invaluable contributions of the non-voting women of the Executive Committee, including Drs. Manda Hall, Gayle Olson, Rashmi Rode, Emily Briggs, Ashley Lucke, and Angela Moemeka, Misty Wilder, MSW, and TCHMB staff members Susan Dimitrijevic, MSN, BSN, RNC-NIC, and Ebony Sherrill, BSN, RN, whose collective expertise supports TCHMB’s mission and helps advance maternal and infant health across Texas.

To learn about the TCHMB Executive Committee members and staff, follow us on social media, subscribe to our newsletter, and view tchmb.org.

Meet Dr. Alice Gong, TCHMB Vice Chair

Dr. Alice Gong is the current vice chair of the Texas Collaborative for Healthy Mothers and Babies (TCHMB). I spoke with Dr. Gong to learn more about her achievements and dedication to improving the health and well-being of newborns.

A Journey Rooted in Curiosity and Compassion

Dr. Gong's career began with a passion for medicine and a particular interest in pediatrics. She grew up in a small town in the Mississippi delta. After completing her undergraduate studies at Mississippi College, she began her journey in healthcare and entered medical school. Although she initially was drawn to pediatrics, it was during her clinical rotations that she was drawn to the complexities of neonatology. The delicate and critical transition that newborns make after birth fascinated her, leading her to pursue a residency in pediatrics and a subsequent fellowship in neonatology.

Significant Research in Neonatal Care Dr. Gong’s training and research has taken place across the United States. Her early research work in neonatology focused on neonatal respiratory distress syndrome, which at the time was the leading cause of death of infant mortality. She was part of some of the initial research on surfactant replacement therapy1, which became a cornerstone of neonatal care and was instrumental in improving mortality and morbidity for premature newborns.

Additional research areas included lung physiology, retinopathy of prematurity in partnership with retinal ophthalmologists, and breastfeeding quality improvement, the latter of which aligns with Breastfeeding Learning Collaborative with Safe Infant Sleep Modeling, a current TCHMB initiative.

A Vision for the Future

Looking ahead, Dr. Gong’s commitment to improving neonatal and maternal healthcare remains strong. As vice chair, she hopes to ensure the progress made in urban hospitals is extended to small community hospitals, particularly those in rural areas. For Dr. Gong, the goal is to elevate care standards in high-level NICUs across the state, regardless of proximity to urban area hospitals.

In her words: "A woman that lives in rural Texas, her wants and desires for her child and her family are no different than someone who lives in an urban area."

A Legacy of Dedication

Dr. Alice K. Gong’s career is a testament to a lifetime of dedication to improving the health of newborns and supporting families in their most vulnerable moments. Through groundbreaking research, system-wide improvements, and a compassionate approach to neonatal care, Dr. Gong has changed the trajectory of countless lives. Her work continues to inspire future generations of healthcare professionals and advocates for maternal and neonatal health.

Her personal mission mirrors that of TCHMB, which works to advance healthcare quality and safety for all Texas mothers and babies and finds success in its collaboration-based efforts. Both Dr. Gong and TCHMB work to ensure better care standards can flourish across the state.

As she reflects on her career, Dr. Gong's mission remains clear: to create a world where every baby can grow up healthy, safe, and nurtured by their families and communities. Her legacy is one of scientific achievement and a profound expression of her compassion and commitment to improving the world for the most vulnerable.

Results from NAT Initiative show promising, meaningful clinical improvements in newborn healthcare

The NAT Initiative Executive Summary delivers background and overview information, results, key findings, and lessons learned from the Newborn Admission Temperature initiative.

The Newborn Admission Temperature (NAT) Initiative was the first TCHMB project to measure outcomes disaggregated by race and ethnicity from hospitals, an important step toward understanding and reducing disparities in perinatal healthcare and health outcomes in Texas. Of particular note are the following findings:

• The findings of decreased hypothermia among NICU admissions — in NICUs that consistently reported race and ethnicity disaggregated data — highlight the potential of statewide initiatives for improvement in settings caring for the most vulnerable newborns.

• The NAT Initiative identified significant disparities in hypothermia incidence, with newborns of non-Hispanic Black mothers having approximately twice the incidence compared to newborns of non-Hispanic White mothers.

More key findings, data, and conclusions & future directions are available in the NAT Initiative Executive Summary.

Learn about postpartum preeclampsia in the emergency department

Recognition and Response to Preeclampsia in the Emergency Department

Speaker:

Catherine Eppes, MD, MPH
Maternal Fetal Medicine Physician Baylor College of Medicine Division
Director, Maternal Fetal Medicine Chair, TCHMB
Executive Committee Faculty Medical Director, TexasAIM initiative

Useful links:

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