Early one humid August morning, I concentrated on the deep blue sky during my contractions on our way to the hospital. Nervous and excited for the arrival of my first baby, I watched a shooting star glisten across the velvety vastness.
Less than 10 hours later, I welcomed my exquisite daughter Willow into our world.
Despite my prenatal requests to have her laid upon my bare chest immediately after birth, I found myself struggling to simply see her curly red hair through the chaos of the delivery room. She was whisked from me for unnecessary examination.
Under glaring lights, gloved nurses poked and prodded my new baby. Loud requests for dad to take pictures filled the room.
Willow’s worried cry called above the commotion. I watched her arms flail as if reaching for me.
What felt like many moons later, a nurse handed my tightly bundled baby to me. She was frowning. I kissed her forehead; an apology for not protecting her from a traumatic birth experience.
Although Willow is happy and healthy (and nursing) 21 months later, I will always feel responsible for allowing her to be welcomed into this world in such an aggressive manner.
Guilt aside, typical hospital births have other significant consequences like unnecessary interventions and difficult breastfeeding initiation.
Nurturing early breastfeeding
But with the launch of the Baby-Friendly Hospital Initiative (BFHI) in the early 90s and its continued progress, less and less babies will suffer from traumatic births. Even more, moms and babies will be supported in the beginning of their breastfeeding journeys thanks to the program’s Ten Steps to Successful Breastfeeding which includes helping mothers initiate breastfeeding within one hour of birth (i.e. skin to skin) and allowing mothers and infants to remain together 24 hours a day.
Liz Westwater, MSM, CLC is project manager to Baby-Friendly USA. She became a Certified Lactation Counselor through Healthy Children Project nearly eight years ago and says the course helped her realize that common hospital practices do not support the 80 percent of women who initially desire to exclusively breastfeed.
Within a typical 48 hour stay, standard hospital practices like mother-baby separation and supplementation manage to severely impair a woman’s potential to breastfeed successfully.
Differently, BFHI applies evidence-based practices shown to increase breastfeeding success.
Growing quickly
“We are experiencing unprecedented growth and interest,” Westwater says of the initiative. “To feel that the whole country is changing direction in terms of perspective on importance of breastfeeding is really exciting.”
In fact, Westwater tells me that out of approximately 3,200 birthing facilities in the U.S., nearly 800 hospitals have been designated Baby Friendly or are currently working toward designation. Today, there are over 150 Baby Friendly birthing facilities in the U.S.
Part of the Healthy People 2020 breastfeeding objective includes increasing the proportion of births that occur in facilities that provide recommended care for lactating mothers and their babies to 8.1 percent. Currently, just under seven percent of births occur in Baby Friendly designated facilities.
Westwater says at this rate, she is confident we will surpass Healthy People’s goal before 2020. Celebrate!
“These are really exciting times,” she says. “For many, many years I’ve been involved in promoting breastfeeding and I never thought I’d see this day.”
Because government entities are taking a hard look at breastfeeding outcomes, BFHI has been acknowledged as a key component to improving mother-baby health.
For instance, Surgeon General Regina Benjamin recognizes BFHI’s benefits in her 2011 Call to Action to Support Breastfeeding.
The CDC also recently funded Best Fed Beginnings led by NICHQ, a program designed to increase the number of Baby Friendly facilities in the U.S.
The Joint Commission supports the mission to increase exclusive breastmilk feeding in all hospitals delivering more than 1,100 babies annually. Implementing BFHI’s 10 steps is an efficient way to increase exclusive breastfeeding.
Promoting collaboration
Achieving Baby Friendly status is certainly an earned accomplishment, but Westwater says the hard work is worth it.
“We think one of the most important things hospitals need to do first is to form a breastfeeding task force or committee,” she says.
Support should come from all areas; a multidisciplinary committee including administration members, nurses, physicians, lactation professionals, laboratory staff, etc. are all essential to achieving Baby Friendly status.
Often times, birthing facilities express concern about BFHI’s perceived financial commitment, namely purchasing artificial baby milk. The BFHI requires hospitals to pay fair market value for formula because it leads to greater objectivity without any ties to other commercial interest as BFUSA Executive Director Trish MacEnroe puts it in a MilkforThought interview.
Fortunately, MacEnroe says it’s not an insurmountable challenge.
“What we have found is that when hospitals get their exclusive breast milk feeding rates up to their highest possible levels, they are completely surprised by how much infant formula they actually need to purchase,” she continues in the MilkforThought interview.
Westwater cites resistant staff members as another challenge. However, this too is a very achievable task.
For example, Westwater says that observing skin to skin after birth will “make believers out of people.”
“I don’t see how you wouldn’t be moved by experiencing skin to skin,” she says.
Several hospitals even successfully implement skin to skin immediately after c-sections and less typical birth outcomes. Read more about skin to skin and c-sections here, here and here.
Continued benefits
Besides the obvious benefits of becoming Baby Friendly, the initiative offers hospitals less publicized rewards.
“We have anecdotal reports from hospitals using it as a marketing tool to increase patient population,” Westwater says.
When patients have positive birth experiences, they are more likely to return for other needs.
And because we know that breastfeeding offers an environmentally conscious infant feeding method, BFHI contributes to the protection of our planet by reducing artificial baby milk waste in its production, delivery and consumption. When mother becomes a heating and stabilizing source for baby after birth as opposed to expensive machinery, our environment also reaps the benefits.
Even more BFHI serves the entire family, not just the mother baby couplet.
“Families should know it helps with family bonding,” Westwater says of delivering at a Baby Friendly facility. “Their family relationships are going to be stronger; they’re going to be healthier.”
For more information about BFHI, please visit: http://www.babyfriendlyusa.org/.
My hospital has been doing skin to skin after cesarean birth for a little over a year with great success. I was fortunate enough to facilitate a cesarean birth with triplets this month where all three babies went skin to skin with mother immediately after delivery and where the babies nursed while on the delivery table. One of the highlights of a 36+ year nursing career. If anyone would like to talk about it, I will be glad to share our information. There are videos and pictures on our facebook page: Family Birth Place-Cape Coral Hospital.
Thanks for sharing your experience, Nancy! Congratulations on your work helping moms and babies.