Is Your Hospital "Baby Friendly?"

Pediatrics, the American Academy of Pediatric's Official Journal, published a study today entitled, "Baby-Friendly Hospital Practices and Meeting Exclusive Breastfeeding Intention."  The purpose of this study was "to describe mothers’ exclusive breastfeeding intentions and whether Baby-Friendly hospital practices are associated with achieving these intentions."  The Centers for Disease Control and Prevention (CDC) surveyed pregnant women about their intentions for exclusive breast-feeding (meaning only breast milk but no other liquids or solids) and then followed up with surveys conducted monthly over a year.

The study found that 85% of mothers had intended to exclusively breastfeed for the first three months.  However, only 32% (about 1/3) of mothers had actually breastfed as long as they had intended.  The study found that "increased Baby-Friendly hospital practices, particularly giving only breast milk in the hospital, may help more mothers achieve their exclusive breastfeeding intentions."

What exactly is a "baby-friendly hospital practice?"  In 1991, UNICEF and the World Health Organization (WHO) started the Baby-Friendly Hospital Initiative (BFHI).  The purpose of the BFHI was to, "ensure that all maternities,whether free standing or in a hospital, become centers of breastfeeding support."  There are currently 152 countries around the world implementing this initiative.  The United States even has an accrediting body for this initiative.  This organization, called Baby-Friendly USA, is a non-profit organization that implements the BFHI in the United States.

"A maternity facility can be designated 'baby-friendly' when it does not accept free or low-cost breastmilk substitutes, feeding bottles or teats, and has implemented 10 specific steps to support successful breastfeeding."

The 10 specific steps are:

1 - Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
3 - Inform all pregnant women about the benefits and management of breastfeeding.
4 - Help mothers initiate breastfeeding within one hour of birth.
5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 - Give newborn infants no food or drink other than breastmilk, unless medically indicated.
7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 - Encourage breastfeeding on demand.
9 - Give no pacifiers or artificial nipples to breastfeeding infants.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

According to the CDC, "Hospitals that wait to start the first breastfeed, or separate babies from mothers, or routinely give formula to breastfeeding babies make it harder for mothers and babies to be able to breastfeed.  When hospitals support mothers to feed their babies only breast milk, it helps mothers to continue feeding only breast milk at home."  Also, "babies who are fed formula and stop breastfeeding early have higher risks of obesity, diabetes, respiratory and ear infections, and sudden infant death syndrome (SIDS), and tend to require more doctor visits, hospitalizations, and prescriptions."

When I had my first child, I could not understand why we could not have our baby sleep in a "nursery."  As any new parent will tell you, those first few hours after birth can be exhausting and you just want to get some rest.  However, my hospital refused to let the baby leave my side.  At the time, I could not figure out why.  In retrospect, they were only practicing the steps outlined by the BFHI.  The hospital we had our baby initiated breastfeeding immediately after birth, had a lactation consultant who made daily visits, only allowed "rooming in," did not give pacifiers or artificial nipples and most importantly, did not give us any samples of formula.

I thought that my hospital was "unique" in this since many of my friends who had babies at other hospitals had been given formula samples, pacifiers, and other things prior to leaving the hospital.  However, on March 30, 2012, a "letter was sent to 2600 hospitals across the country. Over one hundred organizations signed on to the letter calling on hospitals to stop allowing formula companies to market infant formula in their facilities."

Mothers already face many obstacles when trying to initiate and maintain breastfeeding.  As mentioned in earlier posts regarding maternity leave in the US and breastfeeding and the working mother, we can now add, un-baby friendly hospitals to the list of obstacles facing mothers who are breastfeeding.