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Baby Friendly USA

Updated on July 2, 2012

Best breastfeeding practices

Choosing a Baby Friendly Hospital

Is your hospital baby friendly? What, really you ask?? You think, well they have delivered babies there forever. I was born there, my mother, sisters and neighbors had their babies at our local hospital and had no complaints, so of course it must be baby friendly. That is the common assumption. They were told what to do to comply with the hospital routines, and did as they were told. Contrary to popular belief, just because a hospital has an obstetric unit, that doesn’t mean they give the best care possible.

As a matter of fact the World Health Organization (WHO) has recognized that not all hospitals where babies are born provide optimal care to the newborn. Looking at evidence based medicine for the best health of the newborn, WHO devised criteria for optimal care called “Baby Friendly”, the purpose of which is to encourage all mother to breastfeed. The following is quoted from The Baby Friendly USA website:

The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding. The BFHI assists hospitals in giving mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.

Notice they do not ban formula feeding, but offer guidelines for safe feeding.

The Ten Steps to Successful Breastfeeding
The BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States 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.

The CDC issued their statement October 13, 2011:

The Centers for Disease Control and Prevention has awarded nearly $6 million over three years to the National Initiative for Children’s Healthcare Quality to help hospitals nationwide make quality improvements to maternity care to better support mothers and babies to be able to breastfeed. The goal of the project is accelerate the number of U.S. Baby-Friendly hospitals.

This project will address the need to improve hospital practices to support breastfeeding by helping hospitals move toward Baby-Friendly status. The core of the Baby-Friendly Initiative are the Ten Steps to Successful Breastfeeding, a bundle of science-based practices established by the World Health Organization and UNICEF as global criteria to improve breastfeeding rates. These criteria are endorsed by the American Academy of Pediatrics.

For the full statement you can search CDC Baby Friendly.

To find out if the hospital where you plan to deliver is Certified Baby Friendly, you can go to their web site: and follow the links to your neighborhood, or just search by zip code. Another way to search is from the website of the Breastfeeding Task Force LA:

Just because the hospital in your community is not listed, don’t despair. Many hospitals are working towards certification and have begun to implement many of the steps. You can always call the hospital OB unit and ask. If the reply is negative, inquire if they are aware of the status of neighboring facilities. If you are unable to switch hospitals for insurance reasons, one way to implement change at your designated place is during the hospital tour, bring up the topic for discussion. Make the point of how being “Baby Friendly” is so much healthier for the newborns and it would be great if they decided to go along with the CDC recommendations. Bring the other parents into the discussion also, many of them I’m sure would be grateful for the additional information.

Remember this is your baby, if an OB unit tells you “We always give the babies some formula” you can tell them you will sign a medical release form, so your baby does not have to get formula.


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