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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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