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Baby Steps for Breastfeeding Success

Maternity Care Practices

The maternity care experience exerts unique influence on both breastfeeding initiation and later infant feeding behavior.

In the United States, nearly all infants are born in a hospital, and even though their stay is typically very short, events during this time have a lasting meaning. Correspondingly, the hospital stay is known to be a critical period for the establishment of breastfeeding. Breastfeeding is an extremely time-sensitive relationship. Experiences with breastfeeding in the first hours and days of life significantly influence an infant's later feeding. Because of its inextricable relationship with the birth experience, breastfeeding must be supported throughout the maternity hospital stay, not postponed until the infant goes home.

Evidence shows that institutional changes in maternity care practices effectively increase breastfeeding initiation and duration rates. These changes can be part of a comprehensive set of changes, such as those implemented in pursuit of BFHI (Baby Friendly Hospital Initiative) designation or they can be individual interventions such as increasing the rooming-in of mothers and babies or discontinuing polices that are not evidence based.

 - The CDC Guide to Breastfeeding Interventions

The BFHI Ten Steps to Successful Breastfeeding are as follows:

  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 a half-hour of birth.
  5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.
  6. Give newborn infants no food or drink other than breast-milk, 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 artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.

Baby-Friendly USA is responsible for designating BFHI facilities in the United States.