Collaboration promotes Baby-Friendly Hospital Initiative

Tobey Hospital staff at its press event announcing Baby Friendly designation.

A laminated sign hung on the nursing staff’s entrance at Tobey Hospital announcing the newest Baby-Friendly designated medical facility in early summer 2011.

Nurse Manager of Family Centered Unit at Tobey Hospital Southcoast Hospitals Group Mary Ellen Boisvert, RN, MSN, CLC, CCE reports ecstatic squeals as employees read the exciting award.

“We were so elated,” Boisvert says of receiving Baby-Friendly designation.

Working together  

Baby-Friendly USA recently designated its 150th facility. The prestigious award is most certainly something to celebrate; “Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity” according to a 2005 Pediatrics publication.

As a mother who did not deliver in a Baby-Friendly Hospital and initially struggled with breastfeeding because of that, I find Tobey’s dedication to normal birth and breastfeeding exciting and inspiring. The hospital’s Baby-Friendly appointment separates it from other medical facilities, but its collaboration with other medical facilities to inform and assist them in their Baby-Friendly journey is what really deserves applause. Since its designation, Tobey participates in breastfeeding collaboratives like the Massachusetts MotherBaby Summit to inform and assist others in their journeys to become Baby-Friendly.

Tobey Hospital is part of Southcoast Health System, a not-for-profit community based health delivery system which offers an integrated continuum of health services throughout Southeastern Massachusetts and Rhode Island. Southcoast Hospitals Group also includes Charlton Memorial Hospital and St. Luke’s Hospital. The group recently developed a system-wide task force that focuses on promoting things like skin-to-skin immediately after birth to improve breastfeeding rates and duration.

Boisvert says she thinks most medical facilities are excited about the Baby-Friendly Hospital Initiative. In order to make the task manageable though she suggests promoting relationships between hospitals as Tobey has done. Working among colleagues allows for painless execution of plans of action she says.

“That way you don’t have to reinvent the wheel,” Boisvert explains. “We have to work together to promote the best start for mom and baby. That’s where we all want to be.”

CLC led team

Boisvert tells me about the nursing team at Tobey; they are just as inspirational as she. They seem nothing like the impatient, uninterested and uneducated nurses who interfered with my daughter’s breastfeeding initiation. Instead, Boisvert’s team of nurses express interest in lactation counselor certification (CLC) because they genuinely want to help their patients.

“It became something [we] saw as valuable,” Boisvert says of the CLC training. “We want to be able to give full care, whatever needs our moms and babies have.”

Currently, nearly 30 percent of Tobey’s nursing staff are CLCs and several more express interest in coordinating near future training.

“Breastfeeding is part of the whole package of a mom and baby,” Boisvert says. “And in order to give complete care to that couplet, before delivery, you have to be setting them up for success.”

Boisvert stresses the importance of creating an environment that encourages breastfeeding and she says that her CLC training has helped her put that into practice.

Somewhat simple tasks

Tobey has always been committed to natural birth; the least amount of intervention provides the best outcome for mother and baby. This ideology made for a relatively simple Baby-Friendly assessmentbecause many of the requirements were already well ingrained in Tobey’s culture, Boisvert explains.

Tobey Hospital’s press event announcing the Baby Friendly designation back in August 2011.

Tobey eliminated its free formula giveaways nearly five years ago. As of July 2012, all Massachusetts maternity facilities are bag-free. To find out about the status of hospitals in other states, visit

Several years ago Tobey also stopped accepting pens, measuring tapes, due date wheels, crib cards and other vendor promoting materials. Tobey now advertises itself on crib cards. Boisvert says ceasing to accept free products did not set them back financially. She also explains that the hospital no longer sends mixed messages to its patients.

Uninterrupted skin-to-skin contact immediately after birth was a fairly simple qualification for Tobey to meet as well.

“It was so much easier than we expected it to be and it’s because the benefits showed themselves,” Boisvert says.

As for the no-pacifier requirement, Tobey staff simply picked a date and removed them all from the facility. When medically indicated, pacifiers are used, for example with premature infants. Tobey staff provide education to parents who request pacifiers when not medically indicated.

It is so refreshing when evidence-based research is actually practiced. When my daughter and I were in the hospital, one of the nurses advised I give her a pacifier so she wouldn’t “tear my nipples up” with her constant desire to suck “for no reason.” I’m hopeful that, with Tobey’s and others’ dedication to promoting BFHI, maternity facilities everywhere will adopt its guidelines so that all moms and babies can reap the initiative’s benefits.

Minimal challenges

Tobey’s Baby-Friendly journey was not travelled challenge-free. Boisvert says that while they have always promoted rooming in with mom and baby most of the time, their biggest challenge was keeping mom and baby together all of the time. She says the nurses believed they were doing mothers a favor by taking babies to the nursery.

“One of our leadership nurses who didn’t see how [rooming in] was going to work, became one of the biggest supporters,” Boisvert says.

Practicing rooming-in around the clock allows for more efficient procedures like PKU and hearing tests to be completed Boisvert explains. Even the small population of bottle-fed babies at Tobey remain close to mom during these procedures.

When considering Baby-Friendly designation, it’s always important to consider these promising stories of success especially when the initial task seems daunting or impossible.

Collaboration with facilities already awarded the designation can be a vital resource when embarking on the Baby-Friendly voyage.

For more information about the Baby-Friendly Hospital Initiative, visit or Baby-Friendly USA on Facebook.
More information about Southcoast Health System is available at
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