Our hospital has been exploring the Baby Friendly Hospital Initiative. In case you’ve never heard of Baby Friendly Hospital in a nut shell, it is a global “best practice” standard for supporting breastfeeding in the hospital setting. The initiative identifies 10 research based practices that will offer women and babies the best chance to be successful breastfeeding. The 10 steps look fairly simple to the casual observer, but in reality, many hospital struggle. Most of our common newborn care practices, such as formula discharge bags, and early separation of mothers and babies for weighing and baths are not supportive of breastfeeding, deeply entrenched and very difficult to change. There are only 90 hospitals in the US who have achieved the Baby Friendly status and this fact alone makes us ask why?
Breastfeeding is one of the most researched health practices you could find. Every professional organization associated with mothers/infants supports and encourages the 10 steps. The US government CDC (center for disease control) identifies breast feeding as the primary step in ensuring a healthy newborns start in life. What more could you want to answer the question why not. I’ve been aware of the Baby Friendly Hospital Initiative, the first mention of it in 1990 or so. I have only recently taken the process and decided it was doable. First of all I am just beginning to understand how much work is involved. As the lactation nurse in our facility the bulk of the planning and managing this process will be with me and my supporters. I am ready to take on the process. Most hospitals take at least 2 yrs. and as long as 7 yrs. to be ready for the Baby Friendly Hospital organizations examination visit. If you’ve ever been involved with the Joint Commission Certification visit you can expect a similar process, and if you’ve never been part of Joint Commission think of an Internal Revenue Service audit. I do not take this lightly.
The process needs support from all the hospitals staff. I am fine explaining the need for a quality support for a breastfeeding mother/infant to the OB staff I work with but what about the CEO or the head of Radiology or ER? Will I need to have support and help from them, yes. It is called the Baby Friendly Hospital Initiative, not the Baby Friendly OB dept. A mother needs support from all health professionals she might encounter, from the admission secretary who asks her about her admission to ER for mastitis, to the physician who will prescribe medications she can take while continuing to nurse her baby. We’re all needed in the process. Collaboration is essential to a new family’s success.
Moms and babies appreciate all our help
The science is clear. The perfect start for a human infant, is to nurse from it’s mother. This is not always how things work out for many reasons. We can’t solve all the problems but we can do our best to give families a good start. We need to have help from all of our partners in order to effectively incorporate the 10 steps I had a conversation recently with one of our Drs. about Baby Friendly and how MORE emphasis on breastfeeding would make his job even harder. He sees mothers in the very early post partum period and some of the mothers are miserable,; no sleep, difficulty getting the baby to feed, babies who have lost weight and the mothers feeling guilty. How can we possibly make it even harder for mothers and new families? I let him talk, mostly because I couldn’t get a word in, but he was talking about the problems they see at a critical moment . Our current breastfeeding initiation rate is almost 90%, but quickly drops in the first few months. The statistics also show that the Dr. has identified exactly where we have problems. We can start a family but the real problems come in the first few days and weeks home. Timely support for a mother will help the mothers and physicians too. Our OB department has talked about putting together a lactation clinic but the talk with this Dr. helped me see how important early help would be. If a mother could get help early her success would make the physicians job easier too. This discussion led to our clinic becoming a reality. We invite mothers to return to our clinic for hands on help and include this first visit in their hospital cost. Mothers are encouraged to come for an appointment if they experience difficulty.
In reality, the real cost expense is minimal. In an Economic Cost Analysis (U of Texas Health Sciences Center at San Antonio Janet Williams MD, 2009) This document estimates an increase cost per delivery in the range of 1-5% in the initial year but falling to less than 1.5% in 5 yrs. across all delivery types. The long run benefits to baby friendly includes better patient outcomes, higher patient satisfaction, higher staff satisfaction, and positive community support. Our own data collection can support the investment that we commit to this project.
A major reason hospitals avoid the Baby Friendly process is that it sounds expensive. Why should an institution, in this day of fiscal problems, take on a project like this.? Up front the process identifies a 4 Step process with a total of $6000 in fees. The final step also brings in a two person team of professionals who conduct the review over 2 -3 days. The team is paid for their travel, expenses and time. Generally and additional $2-3,000. In addition, the hospital funds education to staff, the cost of formula, nipples and bottles. The hospital administration must be supportive of this kind of capital expense. Our mother baby staff can easily explain the value of the mother baby bond but we need to explain this expense in a more concrete perspective. Recently, AAP came out with a cost analysis of suboptimal Breastfeeding in the US . They reveal that if 80-90% (our rate of initiation) exclusively nursed for 6 mo. The us could save $13 billion. Our partners in public health can acknowledge the value in increased breastfeeding in just the cost of supplying formula for low income families. The value in a healthier community, especially in low income infants and children is valuable for any community health system. The Baby Friendly Hospital Initiative program has research that shows increased initiation and duration with the initiation of the 10 steps. The value of working together to bring better health care to our community from the very beginning of life is worth our best efforts.
By seeking the Baby Friendly designation we commit ourselves to doing our very best that fits our hospital mission of a Christ centered organization, offering compassionate, quality care to all in our community. By becoming A Baby Friendly Hospital we tell our community that the health of our youngest citizens is important and worth our very best. If you want to learn more about the Baby Friendly Initiative go to www.babyfriendlyusa.org.
