The First Year of Parenting
Breast-Feeding and Baby-Friendly Hospitals
Not so long ago, it didn’t seem likely that Boston Medical Center (BMC) would ever become an internationally recognized site for breast- feeding excellence. At the cash-strapped inner-city hospital with a maternity ward that treats mostly poor women of color, it seemed that time and money would be better spent on things other than increasing breast-feeding initiation rates.
“Everyone said BMC was an unlikely place for this to happen,” says Bobbi Philipp, MD, a BMC pediatrician and one of three cochairs for the hospital’s breast-feeding task force. “It was outside attitudes that made us want to prove to the world that our mothers and babies deserved to breast- feed just as much as anyone else.”
Convinced of nursing’s health benefits, BMC’s breast-feeding task force began the process of becoming an internationally recognized “Baby-Friendly” hospital, a designation created by the World Health Organization and the United Nations’ International Children’s Emergency Fund to acknowledge hospitals that take the Ten Steps to Successful Breastfeeding. The steps are:
- Maintain a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff in skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within one hour of birth.
- Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
- Give infants no food or drink other than breast milk, unless medically indicated.
- Practice “rooming in”—allow mothers and infants to remain together 24 hours a day.
- Encourage unrestricted breastfeeding.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.10
In December 1999, BMC earned a Baby-Friendly designation, making it just the twenty-second hospital in the United States with such an accreditation. In the years since, the number of Baby-Friendly hospitals in the United States has grown, but not much. As of December 2006, only 55 hospitals in the United States were considered officially Baby-Friendly, though the designation has been awarded to more than 19,000 hospitals in other parts of the world—including 6,500 in China alone.
The campaign at BMC has paid off in hospital-wide breast-feeding initiation rates that range between 82 and 88 percent, according to Philipp, who adds that these numbers are remarkable because poor African-American mothers—who make up more than half of the women giving birth at the hospital—generally have very low breast-feeding rates.
“One of our proudest achievements is that we’ve been able to take what was once a formula-feeding culture and turn it into a breast-feeding culture,” Philipp says. “Our moms are behind this change, too. We’re busting stereotypes here; we’re all proud of that.”
End of excerpt.
10. Baby- Friendly USA, “The Ten Steps to Successful Breastfeeding,” accessed at www.babyfriendlyusa.org/eng/10steps.html on February 20, 2007. [back to text]
Excerpted from Chapter 15: Feeding Your Baby in Our Bodies, Ourselves: Pregnancy and Birth © 2008 Boston Women's Health Book Collective.
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