Baby-Friendly Hospitals on Horizon

Breastfeeding support is vital for both mothers and babies

/ Author:  / Reviewed by: Joseph V. Madia, MD

Breastfeeding is one of the most effective preventive measures a mother can take to protect the health of her infant. It lowers medical costs, provides invaluable immunities, and helps protect against childhood obesity and many other illnesses including diabetes, sudden infant death syndrome, respiratory and ear infections.

The American Academy of Pediatrics recommends babies be fed nothing but breast milk for about the first 6 months and continue breastfeeding for at least 1 year. Yet only five percent of babies in the United States are born into hospitals that have practices in place which support breastfeeding.

The Centers for Disease Control and Prevention conducted a study in August 2011 which found that most U.S. hospitals do not fully support breastfeeding. When a medical facility waits to start the first breastfeed, separates babies from mothers or routinely gives formula to breastfeeding babies, it makes it much harder for mothers and babies to be able to breastfeed.

Even mothers who want to breastfeed have a hard time without hospital support; one in three mothers will stop without such support from birth. Although most babies in the country begin life breastfeeding, half have been given formula within the first week and by nine months old, only 31 percent of babies are receiving any breastfeeding at all. But studies have shown that breastfeeding for nine months will reduce a child's chance of becoming overweight by at least 30 percent.

Primarily breastfeeding for at least six months has also been associated with children's academic success later in life, according to a study published in Pediatrics, the journal of the American Academy of Pediatrics. Ten-year-old children who were predominantly breastfed for six months or longer in infancy had higher academic scores than children who were breastfed for less than 6 months. Boys were particularly responsive (in mathematics, spelling, reading, and writing) to a longer duration of breastfeeding.

It's better for the mother and society as well. Mothers who breastfeed have lower risks of breast and ovarian cancer, and low rates of breastfeeding add $2.2 billion per year to medical costs.

It's clear that hospitals play a major role in helping or hindering successful, long-term breastfeeding. The World Health Organization and UNICEF have outlined ten global criteria that create a Baby-Friendly Hospital, which will increase breastfeeding rates by providing much more support to mothers. Currently, only five percent of babies are born in such facilities, but the CDC has awarded nearly $6 million over the next three years to the National Initiative for Children’s Healthcare Quality (NICHQ), to help hospitals nationwide make quality improvements to maternity care and breastfeeding support.

“We need to help hospitals improve their maternity care to better support breastfeeding," said William H. Dietz, MD, Ph.D., director of CDC’s Division of Nutrition, Physical Activity and Obesity. "This project takes steps to do that, and it offers real solutions to improve the health of mothers and babies.” The Baby-Friendly Hospital Initiative is endorsed by the American Academy of Pediatrics.

NICHQ will increase the number of Baby-Friendly facilities in the U.S. by:

  • Bringing together staff throughout a hospital, including experts in breastfeeding and quality improvement, organization leadership, and other hospital workers to encourage system-level changes supportive of breastfeeding.
  • Completing a full range of activities to share best practices and lessons learned and develop evidence-based improvement plans.
  • Facilitating collaboration among facilities by enlisting experts in maternity care, breastfeeding, quality improvement, and other aspects of the Baby-Friendly Hospital Initiative.

The UNICEF/World Health Organization Ten Steps to Successful Breastfeeding for the U.S. 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

Review Date: 
October 18, 2011