Will Your Baby Be Born in a Baby Friendly Hospital?

If you plan to birth your baby in a hospital, then choosing a Baby Friendly accredited hospital means that you have a better chance of establishing breastfeeding successfully and going on to exclusively breastfeed your baby for a longer period of time.

Do you know what the Baby Friendly Hospital Initiative is?

The Baby Friendly Hospital Initiative (BFHI) was developed in response to several international declarations in 1990, which called for the promotion, protection and support of breastfeeding worldwide. UNICEF and the World Health Organization (WHO) recognised that hospitals and maternity facilities are extremely influential in the process by initiating such practices as rooming-in (having your baby with you in your room), eliminating non-medically-indicated artificial feeding and providing a new mother with much-needed support by informed health care workers.
Accredited Baby Friendly hospitals must comply with the ‘Ten Steps to Successful Breastfeeding’ established by WHO and UNICEF.

  • Step 1: Have a written breastfeeding policy that is routinely communicated to all health care staff.
  • Step 2: Train all health care staff in skills necessary to implement this policy.
  • Step 3: Inform all pregnant women about the benefits and management of breastfeeding.
  • Step 4: Help mothers initiate breastfeeding within a half-hour of birth.
  • Step 5: Show mothers how to breastfeed, and how to maintain lactation, even if they should be separated from their infants.
  • Step 6: Give newborn infants of breastfeeding mothers no food or drink other than breastmilk, unless medically indicated.
  • Step 7: Practice rooming-in – allow mothers and infants to remain together – 24 hours a day.
  • Step 8: Encourage breastfeeding on demand.
  • Step 9: Give no artificial teats or dummies to breastfeeding infants.
  • Step 10: Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital.

Through compliance with the Ten Steps, hospitals give women the best chance of successfully establishing breastfeeding. Worldwide, the duration of exclusive breastfeeding has been found to increase in babies following the implementation of the Ten Steps in hospitals. As would be expected, babies born in hospitals that implement the Ten Steps have been found to have a lower risk of gastrointestinal tract infections and eczemas.

Step 10 is where the Australian Breastfeeding Association comes in. Baby Friendly hospitals in Australia usually have good links with local ABA groups and give ABA literature to women as they leave the hospital. In this way, a woman can continue to be well supported in her breastfeeding for the following months and years.

Who benefits from Baby Friendly?

The woman and her child

  • Consistent care, information and advice. Staff in maternity and paediatric units have a written policy that they understand and follow.
  • Early bonding between mother and baby. Skin-to-skin physical contact immediately after birth in peace, without any unnecessary disturbance, allows psychological and hormonal adaptation as well as colonisation of the infant’s skin with the normal skin flora of the mother.
  • Consistent and skilled help with breastfeeding. Staff members are required to be able to support women who wish to breastfeed.
  • Early initiation of breastfeeding. Babies are not unnecessarily removed from mothers at birth, thereby encouraging their instinctive seeking and suckling behaviours. When mother and baby need to be separated for medical reasons, the mother is helped with expressing her milk and the expressed milk is given to her baby.
  • Mother’s milk is valued. No food or drink other than breastmilk is given, unless there is a medical reason.
  • Breastfeeding is valued. Artificial teats and dummies are avoided.
  • Empowerment. The woman has authority for confidence in her own resource: breastfeeding.

The family

  • The relationship between the mother and baby is protected, as the mother better understands and responds to her child, and is more likely to be satisfied in her role as a mother.
  • Health and development of the infant are enhanced.
  • Health of the mother is also protected.
  • Cost saving is both immediate (artificial baby milks are costly) and long-term (artificially-fed infants have a higher incidence of illness): breastfeeding is the ‘best investment’ a family can make.

The community

  • Recognition of the importance of breastfeeding flows on from the family.
  • There is an increased level of respect for human rights of both women and children, in ensuring access to a normal standard of health through BFHI’s support of breastfeeding.
  • Environmental considerations. Alternatives to breastfeeding have waste products and contribute to environmental degradation in their production.
  • Economic considerations. There are increased costs to employers from parents required to care for ill children who are artificially-fed, as there is a higher incidence of illness and disease in these children. There are also increased costs to scarce health funding due to higher incidence of illness and disease in non-breastfed children and higher incidence of certain cancers in women who have not breastfed their babies beyond the early weeks.

In Australia the Baby Friendly Hospital Initiative is administered by the Australian College of Midwives Inc. However, like the Australian Breastfeeding Association, skilled and dedicated volunteers carry out the bulk of the work. Many of the BFHI-accredited assessors are also ABA breastfeeding counsellors. Other assessors are lactation consultants, midwives, nutritionists, and doctors.

Being substantially volunteer-run, the BFHI has limited resources. If you would like to support the work of the Baby Friendly Hospital Initiative, you can become a BFHI Supporter. A BFHI Supporter subscription supports BFHI Australia activities and so increases the number of exclusively-breastfed babies being discharged from hospitals around Australia. As an official BFHI Australia Supporter you will also receive BFHI Australia News to keep you up to date with BFHI Australia activities and events.

For more information about BFHI in Australia, including a list of accredited hospitals in each State and Territory, visit our website at www.bfhi.org.au. You can also become a BFHI Supporter on the website or alternatively call (02) 6230 7333 for a copy of our brochure.

So if you are birthing in a hospital or birth centre, ask the staff whether the hospital is Baby Friendly accredited. If the hospital is not accredited, you might like to ask them when they hope to achieve this quality measure!

Ingrid McKenzie. Manager, Baby Friendly Hospital Initiative Australia. April 2005

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