Tag Archives | hospital

All-New Staff Development eCourse to Increase Exclusive Breastfeeding from ILCA and InJoy

The International Lactation Consultant Association® (ILCA®) is proud to announce the release of “Practices to Increase Exclusive Breastfeeding: Core Concepts eCourse”, which we have co-produced along with InJoy Birth and Parenting Education. As part of our value to “uphold high standards of professional practice,” we believe that access to quality, standardized education for health professionals is key. This goes hand in hand with our vision of “world health transformed through breastfeeding and skilled lactation care.”

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It is no surprise to anyone in the field that training is lacking for healthcare workers in the science and art of lactation and supporting breastfeeding families. InJoy and ILCA have sought to address the challenge with this eCourse, available completely online.

Hospitals who license the course will also find ideas for additional related group activities in the Facilitator’s Guide. It was designed to provide education to in-hospital maternity care staff and highlights both 10 Steps of the the 10 Steps of the Baby Friendly Hospital Initiative as well as the impact of birthing and postnatal practices on breastfeeding.

For more information and to learn more about how this course might be valuable to you (including the option to view Module 2 in its entirety), please click HERE.

Want to see a sample video?

Check out this one which shows maternity staff how to accommodate skin-to-skin care immediately after birth.

[youtube=http://www.youtube.com/watch?v=dFoibnj6nQY&w=560&h=315]

 

We would love for you to consider this product in two ways:

1. If you work for a hospital or health care facility serving women through childbirth, please share the information about this product with your supervisor or education department.

2. If you are an IBCLC seeking to build your knowledge about the impact of birthing practices and how to support breastfeeding in the early days, consider purchasing the single-user version of this product. For just $35 USD, you will have full access to video, practice tools, handouts, all in an interactive learning environment. Upon completion, you will be eligible for continuing education units, awarded by ILCA. Additional fees apply.

Essential topics covered in the four 20-minute modules:

  • “The Ten Steps” overview, team strategies, and effectively communicating to mothers
  • How to implement skin-to-skin care after vaginal and cesarean births
  • How to teach and assess hunger signs, latch, and infant sucking patterns
  • How and when to help mothers express milk mechanically or by hand

The eCourse includes:

  • Instructive, real-world video examples showing nurses using proven techniques
  • Downloadable practice tools and patient handouts that allow nurses to apply newly-learned concepts right away
  • Engaging case studies, interactive exercises, and quizzes
  • Facilitator’s Guide with ideas for in-service group sessions
  • 1.5 CE credit hours available from ILCA (fees apply)

We strongly encourage YOU to consider how this course could benefit your community or professional growth.

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Applauding Maryland’s Ban the Bags Initiative

The Maryland Breastfeeding Coalition has recently initiated a movement to “Ban the Bags” in Maryland. They sent the following letter and video outlining their efforts to to the CEOs of all birthing hospitals across the state, requesting the removal of all commercial infant formula discharge bags. We applaud their efforts and look forward to hearing how their actions support mothers and babies in Maryland. We hope that their letter and the influence it has can serve as a model for other states and countries to make the same changes in their communities.

banthebagsThe Maryland Breastfeeding Coalition lauds and strongly supports the recent release of the Maryland Hospital Breastfeeding Policy Recommendations by the Maryland Department of Health and Mental Hygiene (DHMH). As part of these recommendations, in an effort to protect and improve maternal and infant health in our state, we write today to urge your hospital to join with all hospitals in Maryland in discontinuing the distribution of commercial infant formula discharge bags. The initiative to ban the practice of marketing formula by health care institutions and professionals in all birthing hospitals is supported by DHMH’s recommendations, as well as other public health authorities, including the American Academy of Pediatrics, the Centers for Disease Control, and the 2011 Surgeon General’sReport.

Banning the bag is feasible!  Your hospital can join those hospitals that have committed to protecting breastfeeding and refuse to act as marketing agents of formula companies.  Several Maryland hospitals have already banned the formula company discharge bags without significant hardship or obstacles. In the process, they have been able to simultaneously increase their marketability.

  • Through working with their purchasing and marketing departments, some like Upper Chesapeake Medical Center and Shady Grove Adventist Hospital have designed and distributed their own discharge “gifts” which advertise their respective hospitals.
  • Johns Hopkins Hospital stopped giving out formula samples over three years ago as part of a hospital-wide effort to stymie the marketing of pharmaceuticals within its facilities.  The hospital administration has chosen not to give out a replacement bag.
  • Other hospitals such as Memorial Hospital at Easton discontinued distribution at the behest of Risk Management upon investigating their liability in the event of a formula recall or a baby getting sick from expired or contaminated formula.

While these hospitals and others no longer hand out formula bags upon discharge, banning the bag never prevents a mother from obtaining free formula samples if she so requests.   She can simply be directed to call the toll-free number on the back of every formula container to receive free bags, coupons, or samples. Your hospital aims to promote the health of infants and mothers, but when providing the bag and/or formula samples, the ongoing promotion of infant formula sends the inaccurate message that these products are medically approved, endorsed, and necessary.

The Maryland Breastfeeding Coalition has prepared a brief power point presentation to highlight the research regarding the effects of formula discharge bags and discuss further how hospitals can approach banning the bags. We encourage you to view and share it with your staff.

[youtube http://www.youtube.com/watch?v=RNxp-0bm-Ms]

For more information, you can browse www.banthebags.org, and Public Citizen .  You can also visit the website of the Massachusetts Breastfeeding Coalition which has successfully led all 49 of Massachusetts’s birthing hospitals to ban the bag.  Our own Maryland Breastfeeding Coalition website will soon contain links to the You Tube video for staff and other resources. Help us make Maryland the next state to successfully put the health of our youngest citizens first by banning the formula discharge bags from all birthing hospitals. Please contact us if the Maryland Breastfeeding Coalition can be of further assistance to you, or if you have any questions.

Please share this information with other relevant departments within your hospital. We very much appreciate your time with this matter.

What is your community doing to eliminate the marketing of formula in your hospitals?

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Establishing a Breastfeeding Clinic in Guadalajara, Mexico

By Barbara Oñate, IBCLC

Before I became an International Board Certified Lactation Consultant (IBCLC), I had the opportunity to visit a friend 24 hours postpartum in the most expensive hospital suite available in my hometown in Mexico. I was truly aghast to see she had such damaged and bleeding nipples. I asked her who was helping her at the hospital and she replied that the nurses told that her she needed to “wipe her nipples and withstand the pain”. You can imagine how desperate I was for my friend so I sat with her and helped as much as possible with what I knew from my own breastfeeding experiences. I went back to the United States amazed by how poorly women were served, even in the most expensive birthing facilities available.  That is when I decided to pursue becoming an IBCLC.

Five years ago, my family and I moved back to Mexico and I was ready to help. There was very little lactation support available in my community and few people were aware of how IBCLCs could impact breastfeeding for mothers and babies.  While studying to meet the requirements for certification,  I worked for free at a local hospital in Guadalajara. The use of formula for infants was “protocol” in my facility and a representative of a formula company regularly did “lactation rounds” in the hospital. I was diligent in my efforts to meet with mothers just after this representative had visited their room and support moms and babies while combating the poor information she had given. I would help the mother and baby latch-on after 10-20 hrs of separation with their babies, fully fed with bottles and formula. Before long, patients began coming to the hospital asking for my help. Not long after, the formula representative simply quit coming and I was left with the whole maternity floor to myself! This is how pediatricians and OB’s started to trust me, call me and even consult with me. I soon began my own private practice.  With the contact hours I was afforded at the hospital and in my practice, I applied for my IBCLC exam and in October 2009, I earn my certification.

As my practice grew, I began noticing that a large number of mothers were wanting to breastfeed but lacked support and the adequate tools. Our country of 120 million people is experiencing a significant lack of IBCLC care (ed. note: IBLCE notes that, as of April 2012, there are 19 IBCLCs in the entire country). I began to contacting those in the community with the power to effect change, asking them how we could provide more support to Mexico’s mothers and babies.  One said to me, “I see your passion about breastfeeding and I can see how important it is for babies and mother’s. I think we have to do something about it”. We recognized together that increasing breastfeeding rates could have a significant impact on Mexico!

We now have a lovely breastfeeding clinic in Guadalajara and we hope to open 14 more throughout Mexico. We are also launching an educational campaign on social media to educate moms and empower them in regards to their breastfeeding “powers” and rights. We are setting up a nationwide breastfeeding call center and we are negotiating with private insurers to provide breastfeeding benefits for all their clients.  We are starting to see wonderful momentum from mothers who are finding the kind of support they deserve. We are devoted to giving to our beautiful country smarter, healthier, and more attached babies, mothers and families.

I think all IBCLCs need to find the power in their passion. We are saving lives every day. We are the soldiers, fighting for infants’ lives and we need to stand tall in every corner of the world. I always tell my trainees, “If we do our jobs right today, we can save families from difficulties or problems they will never know thanks to breastfeeding”.

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A Day in the Life of US Hospital Based IBCLC…

By Christine Staricka, IBCLC

I’d like to open a window for you to see what I experience during the 24-72 hours after birth as a hospital-based IBCLC in the United States.  It may or may not surprise you, but it will definitely broaden your perspective.

A typical day for me and my colleagues begins with accessing a current census report of mothers in the postpartum unit, the NICU, and the pediatrics unit.  Prioritizing patients is one of the most difficult tasks I face.  The reason is simple: every nurse correctly believes that her patient is the most important and needs to be seen immediately. In many cases, when I tell a nurse that her patient will be seen later rather than sooner, I listen to her case assessment and help her by making specific suggestions on how to help get through the next feeding or two.  Every day, I teach as many nurses as I do moms, reinforcing both clinical and assessment skills and reframing perspective in terms of infant health outcomes.

Collecting information on dyads is a time-consuming task.  I consult the charts; check the white board on which nurses write feeding status and significant outcomes for each dyad; talk to nurses and pediatricians; and most importantly, I talk to the mother while I observe her baby at her breast.

Often a postpartum mom is medicated, stressed from a difficult or long birth, and overwhelmed by the sheer number of hospital employees knocking on her door for various reasons. Talking to the new mother is an exercise in proper communication skills to overcome her reluctance to let another stranger into her world and to build credibility and a sense that I am there to advocate for her and her baby.

I ask for her opinion on breastfeeding progress, mentally comparing it with information I have already gathered.  Often she expresses a vastly different picture. She may feel it’s going terrible because the baby wanted to nurse all night and is clearly not getting enough milk, while the nurse has assessed the latch and notes that baby has had 5 stools and 2 wet diapers in the first 24 hours.  Or the mom may say it’s going fine even though it hurts a lot, and she knows that’s normal because all her friends told her that breastfeeding is supposed to hurt; however, the baby lost more than 7% of birth weight in 36 hours and has a high bilirubin level for his age.  Sometimes the answer is obvious but most times, it takes more detective work:  “Tell me about your birth…”

The more you talk, the more opportunity is created to educate, correct myths, and address misperceptions.  In the hospital, many times the moms I see are not yet aware they need help.  She may not even truly want help.  That puts an extra burden on me to discern how much I can assist, and I’ve learned through experience to sense from her responses when it is advisable for me to ask explicitly whether she would like me to work with her, what were her original feeding goals, and how she would like to proceed while still in hospital.

During my hours on the floor, I wear a pager so that patients and staff can find me in the building.  We maintain a lactation helpline where any mom in the community can leave a voicemail if she needs breastfeeding support and I also see moms on an outpatient basis as needed after they have been discharged home.

I do a LOT of paperwork. I am required to document every contact with a mother, short or long, phone or in-person, and also some with nurses where I give specific instructions on how to help.  I am required to document those contacts on my own daily activity log, as well as documenting them in legally-approved patient charting methods, all of which are handwritten in our facility and are subject to subpoena by the courts in case of litigation.  When I have contact with the mother of a baby in NICU, I document in the baby’s chart, plus I also make notes on the contact on an individual dyad tracking sheet to assist with continuity of care among lactation consultants because the physical charts for those babies are not easily accessible to us. I sign in multiple places in patients’ charts that I have provided required education on those topics, and I collect feeding statistics from mothers for hospital reporting requirements.  I compile multiple types of breastfeeding statistics for various purposes within the hospital; sometimes those reports influence policy and procedural changes, a very rewarding direct outcome of my efforts.

I facilitate a monthly breastfeeding support group sponsored by the facility. I assist in formal staff education events held annually for each individual unit within the Maternal Child Health Department.  Our lactation staff doubles as the Parent Education staff (and thus required to maintain current certification as Childbirth Educators) so we are responsible for teaching Childbirth Education Series, Prenatal Breastfeeding Classes, and hosting weekly maternity Orientation Tours of the facility for pregnant women and their partners, in addition to teaching a daily Discharge Class for patients discharging home that day. We create handouts for parents which meet Baby Friendly standards and IBCLC Standards of Care. I am sometimes called upon to assist hospital employees who themselves are facing breastfeeding and/or pumping challenges as they return to work and advocate for them as needed. I collaborate with the local Women, Infants, and Children (WIC) services to ensure individual mothers in need get breastpumps and basic breastfeeding support as needed.

I often wish I was able receive feedback and validation which comes from building a relationship with my patients.  Almost everyone I see disappears into the ether and I never know if I affected them.  Fortunately, there are those beautiful few who call with questions, who come back in for more help, who send lovely thank-you cards, who attend support group, and whose babies I am privileged to see as they grow up.  I feel comfortable speaking for all my hospital-based IBCLC peers in saying that the rewards we reap from just a tiny few of those we meet in our demanding professional setting are enough to make us happy to see the multitudes every day.

Christine Staricka became a Certified Lactation Educator through UCSD while facilitating local breastfeeding support groups. She studied independently while accumulating supervised clinical hours and passed the exam in 2009 to become an IBCLC. She holds a BA in Business Management from University of Phoenix. She has contributed to USLCA’s eNews and she moderates a community-based breastfeeding information and discussion page on Facebook at Facebook called BakersfieldBreastfeeds. She enjoys tweeting breastfeeding information as IBCLCinCA and maintains a blog by the same name. She is a wife and mother of 3 lovely and intelligent daughters and aunt to 4 nephews and 2 nieces, all of whom have been or still are breastfeeding. She is partial to alternative rock and grunge music, especially Pearl Jam, and attends as many concerts as financially possible with her husband of 18 years.

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Interview with Trish MacEnroe of Baby Friendly USA

Lactation Matters recently caught up with Trish MacEnroe, Executive Director of Breastfeeding USA.  While the Baby Friendly Hospital Initiative is well established in many areas of the world, the number of facilities pursuing the designation has soared recently in the US.  Trish gives us a glimpse into the current trends.

1.      Can you give us a brief history of the Baby Friendly Hospital Initiative in the US?

The Baby-Friendly Hospital Initiative (BFHI) is an international recognition and quality improvement program that evaluates hospital practices to ensure the successful implementation of the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) Ten Steps to Successful Breastfeeding and International Code of Marketing of Breast Milk Substitutes. In addition, the Baby-Friendly assessment serves as an external verification of the CDC’s mPINC survey and is a key strategy to sell my settlement for meeting Healthy People 2020 Goals for breastfeeding. At its core, this designation process involves significant quality improvement and organizational change that replaces long-standing practices with new evidence-based practices that have been proven to lead to better outcomes.

The Baby Friendly Hospital Initiative was launched globally in 1991.  In 1992, the US Department of Health and Human Services funded an Expert Work Group to consider how to implement the BFHI in the United States. In 1994, with support from the U.S. Committee for UNICEF, Wellstart International Screen Sharing developed the evaluation tools to implement the BFHI assessment process. At the request of the U.S. Committee for UNICEF, in January 1997, the Healthy Children Project, Inc. accepted responsibility for creating the organization to serve as the designating body for the BFHI in the United States. Since August 1997, Baby Friendly USA, Inc, a non-profit 501(c)(3) organization, is the US national authority for this global breastfeeding initiative.

Currently, 145 hospitals and birthing centers in 34 states are designated as Baby-Friendly Facilities in the United States. 23 hospitals were added in 2011 and 22 more have already received the designation in 2012. Another 675 are working towards designation. The Baby Friendly Hospital Initiative is growing rapidly in this country as more and more birthing facilities commit to becoming Baby Friendly.

 2.      How has the Surgeon General’s Call to Action impacted the practice?

The US Surgeon General acknowledged the benefits of the Baby-Friendly Hospital Designation in her Call to Action to Support Breast Feeding. Baby-Friendly USA, Inc. (BFUSA) is committed to advancing effective strategies that assist hospitals, breastfeeding coalitions, public health entities and funders to work collaboratively in implementing Action 7 of the Call to Action and improve outcomes.

Since the Surgeon General’s Call to Action, the number of local departments of health, breastfeeding coalitions and other community organizations (auto glass replacement houston shops) assisting hospitals in working to become Baby-Friendly designated has risen dramatically. While there is no direct evidence that it is specifically attributable, since the Call to Action was released 512 hospitals have officially begun work on the BFHI in the US.  My opinion is that the surge in hospital interest is the result of a combination of factors: a call to action from the highest levels of the US government, as well as some new funding opportunities to help hospitals change practices.

3. There has been news lately of the Latch On NYC  initiative to “lock up” formula in the hospital?  What is Baby Friendly USA’s stance on such practices?

Mayor Bloomberg and the NYC Department of Health and Mental Hygiene are to be commended for being proactive on a very important consumer protection issue.

Human milk fed through the mother’s own breast is the normal way for a human infant to be nourished.  Breastfeeding is the biological conclusion to pregnancy and an important mechanism for the continued normal development of the infant.  Naturally, things that occur outside the norm have side effects, including health consequences.  The “Latch-On NYC” campaign, which is voluntary for the facilities, asks that mothers be educated about the benefits of breastfeeding, which naturally includes the possible consequences of formula.  Some mothers will weigh the benefits and risks and compare them to other factors in their lives and decide that formula feeding is the best option for their circumstances.  When that occurs, their wishes should be respected.  This is very much in keeping with the tenants of the Baby-Friendly Hospital Initiative.

Another very important point that has been lost in the media frenzy around the Latch-On NYC campaign is that hospitals have standard policies that either limit access to (which is what Latch-On NYC calls for) or “lock up”  most of the products they use.  This is done for patient safety reasons as well as inventory control.  What we really should be asking is why is this not standard operating procedure for infant formula in all facilities throughout the US, and why has the suggestion of it stirred up such a controversy? It just makes good sense.

4.  What is your hope for BFUSA as we move forward in the US?

I can’t wait for the day that the last hospital in the US receives the Baby-Friendly designation.  My hope is that we effectively fulfill our vision of creating an American culture than values the enduring benefits of breastfeeding and human milk for mothers, babies, and society.

Trish MacEnroe is Executive Director of Baby-Friendly USA, treasurer of the NYS Breastfeeding Coalition, and former chair of the WIC Association of NYS. At Baby-Friendly USA, Trish has reorganized the Baby-Friendly designation process and created
tools to assist facilities pursuing designation. Previously, Trish worked for the WIC program, most recently as Director of the NYS WIC Training Center, and oversaw development of training programs for all aspects of WIC including the development of their Breastfeeding Peer Counselor website and curriculum. Trish received her Bachelor of Science degree in Food Science and Nutrition from the University of Rhode Island.

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Informed Consent: What is My Responsibility as a Lactation Consultant? – Reader Response

Doreen says:

August 1, 2011 at 10:35 pm (Edit)

I feel so alone in my profession and this will be a blessing! I have a question that I need help with. My manager at work, in a large hospital, told me that the nurses and physicians had a problem with “informed consent” when it came to breastfeeding. ie: we have mothers who state that they want to breast and bottle feed. I discuss the importance of getting a good milk supply started before introducing a bottle, always asking why. Most mothers state it is because they are going back to work, then I discuss this finding out when they go back, making a breastfeeding plan. The problem is that the nurses want to give bottles without informing the patients about possible consequences as they get their milk supply going for NON medical reasons ie: get sleep at night, second night feeding frenzie, etc. I feel it is my ethical responsibility as a RN and IBCLC to give “informed consent” (ie: information) because most mothers do not understand the consequences of bottles of formula in the first few days and I have made it clear that the nurses have that responsibility also. They do not like this. Any suggestions would be helpful as I have called a meeting of the managers next week. Thanks, Doreen 

Doreen, you raise an important issue for IBCLCs everywhere! 

To be clear:  the issue isn’t whether you “should” provide information and support to a breastfeeding mother, so she can make an informed decision about matters affecting her/her baby’s health.  Rather, the issue is “how” to effectively assist the mother, as her allied health care provider, in a work setting where other caregivers are offering conflicting or erroneous advice.   

ILCA’s recently-published monograph “Risks of Not Breastfeeding” concludes that “[e]xclusive breastfeeding is the normative standard for infant feeding.  Not breastfeeding increases infant and maternal acute and chronic illnesses….  The research demonstrates that there is a dose response to breastfeeding and human milk exposure for mothers and infants.  Healthcare professionals must be aware of the research and find ways to share this information with families so they can make responsible informed feeding decisions for their children.” (Spatz, D., & Lessen, R. (2011). Risks of not breastfeeding. (Monograph).  Morrisville, NC: International Lactation Consultant Association, p. 8)(emphasis added).   Your meeting with your managers is your opportunity to suggest that evidence-based practice is not being followed if non-medically-indicated use of formula is tolerated (and even promoted) by caregivers whose patients are breastfeeding mothers and babies.

You are the ideal healthcare professional to teach families (and colleagues) about human lactation. 

The IBLCE Scope of Practice, “encompassing the activities for which IBCLCs are educated and in which they are authorized to engage” (from the preamble; full IBLCE SOP at http://www.iblce.org/upload/downloads/ScopeOfPractice.pdf) anticipates that as allied health care providers we will advocate for the baby, the mother and the breastfeeding relationship.  It describes IBCLCs as having “specialized knowledge and clinical expertise in breastfeeding and human lactation.”  It describes the IBCLC duty to offer evidence-based information to help mothers meet their breastfeeding goals, and the duty to educate families and healthcare professionals about breastfeeding and human lactation.  Your ethical responsibility to inform, advocate, and educate is bolstered by the IBLCE Code of Ethics requiring, at tenet 11, that the IBCLC “provide sufficient information to enable clients to make informed decisions”  (http://www.iblce.org/upload/downloads/CodeOfEthics.pdf).

All health institutions and health care providers should support and assist breastfeeding families.  In the United States, advocating for breastfeeding as a public health imperative has received significant boosts from highly esteemed entities.  The U.S. Surgeon General’s Call to Action to Support Breastfeeding asks all health care providers, their institutions, employers, families and communities-at-large to support breastfeeding mothers.  (http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf).  This powerful document comes from the US federal government, but its call to action by the community at large is universal, and the concepts are applicable worldwide. 

The Centers for Disease Control recently issued their report concluding that US hospitals have a fairly dismal record when it comes to breastfeeding supportive practices. http://www.cdc.gov/vitalsigns/Breastfeeding/index.html.  And yet, the Joint Commission, which accredits hospitals in the US, now looks at exclusive breastmilk feeding as part of the Perinatal Care core measure set.  Because breastfeeding is the biologic norm, any (unexplained) deviation from it is seen as a deviation from best practices.  The United States Breastfeeding Committee has a toolkit to assist in the explanation and implementation of these core measures (http://www.usbreastfeeding.org/Portals/0/Publications/Implementing-TJC-Measure-EBMF-2010-USBC.pdf).

IBCLCs are specialists in a field that crosses several disciplines.  Our colleagues are not subject- matter-immersed in breastfeeding, as we are.  Use the meeting with your managers as your “toe in the door” to educate them: breastfeeding is the biologic norm and a public health imperative; hospitals can and should do a better job to support their breastfeeding patients, and this is a significant core measure that Joint Commission inspectors will be evaluating. And it is what the family wants and needs, to boot. 

Liz Brooks JD IBCLC FILCA

Liz Brooks is a lawyer, private practice lactation consultant and international speaker on legal and ethical matters affecting IBCLCs.

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Round Table Discussion: Baby Friendly Health Initiative

Protecting, Promoting and Supporting Breastfeeding

What is the Baby Friendly Health Initiative (BFHI)?

Baby Friendly Health Initiative is a World Health Organization (WHO) and UNICEF a worldwide program launched in 1991 following the Innocenti Declaration of 1990 that aims at creating a health care environment that supports mothers and babies to have the best start in life. This may have evolved in your country to suit your specific needs and some examples are; the BFI (Baby Friendly Initiative), BFHI (Baby Friendly Health Initiative) or Baby and Mother Friendly Hospital Initiative. It aims at improving the care of pregnant women, mothers and newborns at health facilities that provide maternity services for protecting, promoting and supporting breastfeeding, in accordance with the International Code of Marketing of Breastmilk Substitutes.

Creating a health care environment where Breastfeeding is the norm, Practices known to promote the health and well-being of all babies and their mothers are followed.

The Ten Steps to Successful Breastfeeding is the minimum global standard by which hospital facilities are assessed and accredited. A ‘Baby Friendly’ facility is one where a mothers’ informed choice of infant feeding is supported, respected and encouraged. Community Health has seven steps.

Baby Friendly Accreditation is a quality improvement measure which demonstrates that a facility offers the highest standard of care to all mothers and babies. Attaining accreditation reflects the commitment of the facilities staff.

To achieve this standard, midwives and other carers obtain an increased knowledge of infant feeding, greater skills and commitment to facilitate breastfeeding. This engenders an environment that encourages best practice, improving the health of new generations.(bfhi.org.au). See additional links below for more information.

Participants:

Angela Smith, RN CM IBCLC FILCA  Nurse Unit Manager

Royal Prince Alfred Hospital Sydney Australia BFHI Accredited 2011

 

Cathy Holland RN, BS, IBCLC, FACCE, LCCE

Over my 46 years as a registered nurse, Women’s Health, focusing on lactation and birth using both traditional and energy medicine to facilitate success is my passion.

 

Trish MacEnroe Executive Director

Baby-Friendly USA, Inc.

tmacenroe@babyfriendlyusa.org

Cindy Turner-Maffei, MA, IBCLC National Coordinator

Baby-Friendly USA, Inc.

 
1. Why should a hospital work toward BFHI certification?

Angela Smith (AS): All hospitals want to provide the best possible care they can and we know that the BFHI accreditation is the Gold Standard in not only Breastfeeding Care but in excellent Postnatal care generally.

Cathy Holland (CH): BFHI accreditation indicates the facility is making efforts to show the community they value infant nutrition, over free products from companies who are more interested in $$$$$$ than mother-baby health.

Trisha & Cindy (TC): The Baby-Friendly Designation is the globally recognized symbol of world-class maternity care practices that lead to optimal infant feeding outcomes.  In this process birth facilities

  • deliver patient-centered care
  • improve health outcomes and patient satisfaction
  • increase community recognition of excellence
  • enhance a professional environment of competence, including leadership and team skills
  • demonstrate a commitment to quality improvement
  • meet corporate compliance requirements

In the US this may also

  • improve m-PINC scores
  • meet Joint Commission maternity care standards for exclusive breast milk feeding
  • lead the way to achieving Healthy People 2020 goals for breastfeeding

2. Why should expectant parents choose a BFHI facility?

AS: Expectant parents like the rest of the population these days will search the internet looking for the hospital that provides the best service. By being BFHI accredited the new parents are reassured that the hospital they have chosen has gone “the extra mile” and will provide them with First class care.

CH: Securing the best possible care should be a concern. Often the choice of facility is “where they have insurance coverage.” A BFHI facility has made an effort, greater than that which is required of them. Having this designation could nudge the insurance payers to notice the BFHI facility. Health and $$$$$ savings are the expected outcomes.

TC: Baby-Friendly birth facilities have taken special steps to create the best possible environment for bonding with and feeding your baby.  The Initiative celebrates hospitals and birth centers that have put in place policies and practices to enable parents to make informed choices about how they feed and care for their babies.   Birthing facilities voluntarily seek out this designation as a demonstration of their commitment to new families.

3.  What does BFHI mean for us (me/my baby/my family)?

AS: The idea of BFHI means quality for each group. For staff it means they know they are working in a hospital that is not frightened of accreditation but is proud of its achievements.  For new parents and families it gives them peace of mind that the facility they have chosen is committed to breastfeeding and giving quality care.

CH: The BFHI means the health facility in my neighborhood is prepared to offer the best possible start for families. Creating health in every way is a great philosophy for a facility.

TC: In a Baby-Friendly birth facility you will have the opportunity to hold your baby skin to skin immediately following birth, you will be able to have your baby stay with you in your room during your entire hospital stay and you will have the confidence in knowing that you are being cared for by highly trained staff who can help you learn to respond to your baby’s specific needs. Staff will also help you to identify supportive resources in your community to help you with infant feeding after you go home.

4. What is some recent research or statistics relating to BFHI?

AS: ‘Baby Friendly’ accredited hospitals in Australia is 77 which is 23% of all Australian hospitals providing maternity services (based on approximate number of facilities being 330).

TC: US STATISTICS

114 designated hospitals http://babyfriendlyusa.org/eng/03.html

4.5% of births take place in Baby-Friendly Hospitals http://www.cdc.gov/breastfeeding/pdf/2011BreastfeedingReportCard.pdf

RESEARCH

The Ten Steps to Successful Breastfeeding have been demonstrated to increase both initiation and duration of breastfeeding

DiGirolamo AM, LM.Grummer-Strawn and SB Fein. 2008.  Effect of Maternity-Care Practices on Breastfeeding Pediatrics122;S43-S49

Merten, S, et al. 2005. Do Baby-Friendly Hospitals Influence Breastfeeding Duration on a National Level? Pediatrics 116; e702-e708.

Philipp BL et al. 2001. Baby-Friendly Hospital Initiative Improves Breastfeeding Initiation Rates in a US Hospital Setting. Pediatrics 108(3):677-681.

DiGirolamo AM, LM Grummer-Strawn, S Fein. 2001. Maternity care practices: implications for breastfeeding. Birth 28:94-100.

Kramer MS et al. 2001. Promotion of Breastfeeding Intervention Trial (PROBIT): A randomized trial in the Republic of Belarus. JAMA 285:413

For more information check out these sites:

http://www.bfhi.org.au/

http://www.unicef.org.uk/babyfriendly/

http://www.babyfriendlyusa.org/eng/index.html

http://www.waba.org.my/

http://www.babyfriendly.org.nz

http://www.who.int

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