In 1990, recognizing that breast-feeding is the healthiest choice for both mother and child, the Innocenti Declaration was created and adopted at the WHO/UNICEF policymakers meeting on Breastfeeding in the 1990s: A Global Initiative.
Co-sponsored by the United States Agency for International Development and the Swedish International Development Authority, 10 steps were developed for their Baby-Friendly Hospital Initiative according to evidenced-based best practices for infant nutrition.
Once hospitals fully implement these 10 steps and pass inspection, they are designated as official WHO/UNICEF Baby-Friendly Hospitals. About 19,000 hospitals throughout the world have received the designation, but only a small percentage of hospitals in the U.S. have earned that distinction.
Expanding Baby-Friendly Efforts
As of Jan. 27, there were 105 Baby-Friendly Hospitals and Birth Centers in the U.S. 21 of those are in the Northeast. But Connecticut is looking at increasing that number within the next few years.
In Connecticut, our first Baby-Friendly Hospital was Hartford 10 years ago, in Middlesex five years ago and St. Vincents this year, says Jennifer Matranga, RN, CCE, IBCLC, consultant for the Connecticut Baby-Friendly Initiative. In March 2010, Connecticut was granted funding by Center for Disease Control so the Connecticut Breastfeeding Initiative could assist 10 more hospitals in achieving Baby-Friendly designation.
Promoting breast-feeding is imperative, says Suzanne Campbell, RN, PhD, WHNP-BC, IBCLC, associate dean of Academic Programs at Fairfield (Conn.) University School of Nursing and chairwoman of the Connecticut Breastfeeding Coalition Education Committee.
We cant ignore this research anymore, says Campbell, who worked as a womans health practitioner. According to BFHI, human milk provides babies with the most complete nutrition possible an optimal mix of nutrients and antibodies necessary for babies to thrive. Scientific studies show that breast-fed children have fewer and less serious illnesses and are less at risk for developing SIDS, childhood cancer and diabetes, than those who never receive breast milk.
Nurses are one of the most important components in successfully implementing BFHI.
Many hospitals still follow the old-fashioned team nursing model, and the nursery is full of crying babies all night, says Matranga. Mother-baby care is the preferred option where the nurse cares for mother and baby and keeps them together in family-centered care. If the hospital cannot get nursing to change to the couplet care or mother-baby care model of nursing, it will be hard for the mother with baby separated from her in the nursery and hard for the baby to get organized to nurse well. If the family is choosing to formula feed, it is still vital for infant to be rooming in so proper and safe formula preparation can be taught and infant feeding and calming cues can be learned by the family.
Incorporating Evidence-Based Methods
Becoming a Baby-Friendly hospital means not only procedural training in implementing the 10 steps but also often changing long-established routines after the birth of a child.
The challenge in America is our culture that is often much more bottle-feeding friendly, says Matranga. [We] need to teach from evidenced-based practice and not personal experiences.
Step 2 of the initiative focuses on healthcare staff education, while steps 4 through 9 address the clinical changes that need to take place in the hospital.
The strength of the coalitions involvement rests in our mission to improve Connecticuts health by working collaboratively to protect, promote and support breast-feeding, says Michele Griswold, RN, MPH, IBCLC, chairwoman of the Connecticut Breastfeeding Coalition. The collaborative nature of our organization allows us to draw on the many stakeholders necessary for the ultimate success of a program of this scope.
For example, Griswold says, the coalitions many members who are working in the hospital setting have substantial knowledge and expertise in the field of breast-feeding and can provide support for policy change within their own institutions. Having the opportunity to approach breast-feeding promotion from a collaborative perspective is invaluable for the success of this program. It has the potential to improve health outcomes for mothers and children in Connecticut, she says.
For more information, visit www.babyfriendlyusa.org.