Logan Reid
Breastfeeding is widely recognised as the best source of nutrition for infants, offering short- and long-term health benefits. In 1991, the World Health Organization (WHO) and UNICEF developed the Baby-Friendly Hospital Initiative, a program that encourages hospitals and birthing centres to promote breastfeeding. This initiative outlines ten steps to successful breastfeeding, including skin-to-skin care and rooming-in, with the goal of improving breastfeeding rates and providing mothers with the support they need. While some hospitals have implemented these strategies, there is criticism that they may pressure mothers to breastfeed and that they do not necessarily improve long-term breastfeeding rates. Despite this, the initiative has led to an increase in the percentage of births in hospitals with recommended maternity care practices that support breastfeeding.
| Characteristics | Values |
|---|---|
| Is breastfeeding mandatory in hospitals? | No, but hospitals are encouraged to promote breastfeeding. |
| What is the recommended infant feeding method? | Breastfeeding is the clinical gold standard for infant feeding and nutrition. |
| What are the benefits of breastfeeding? | Breastfed babies have lower risks of asthma, allergies, childhood obesity, and gastrointestinal problems. Breastfeeding also reduces the risk of certain health conditions for mothers. |
| What is the Baby-Friendly Hospital Initiative (BFHI)? | A program developed by the World Health Organization (WHO) and UNICEF in 1991 to encourage hospitals and birthing centers to promote breastfeeding. |
| What are the Ten Steps to Successful Breastfeeding? | Guidelines developed by WHO and UNICEF as part of the BFHI, which include skin-to-skin care, rooming-in, no pacifiers, and no formula unless medically necessary. |
| How common is exclusive breastfeeding? | About 1 in 4 infants are exclusively breastfed as recommended until they are 6 months old. |
| How has the BFHI impacted breastfeeding rates? | The percentage of births in hospitals with recommended maternity care practices that support breastfeeding increased from 3.8% in 2010 to 28.9% in 2021. |
| What support is available for mothers who choose to breastfeed? | Initiatives in hospitals, workplaces, and communities aim to create supportive and safe environments for breastfeeding mothers. |
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What You'll Learn
Benefits of breastfeeding
Breastfeeding has several benefits for both the mother and the baby.
Benefits for the baby
Breast milk is the ideal source of nutrition for infants, providing them with the perfect balance of fat, sugar, water, protein, carbohydrates, and vitamins to support their growth and development. It also contains antibodies that protect against common childhood illnesses and infections, such as:
- Diarrhea
- Stomach flu
- Ear infections
- Asthma
- Obesity
- Type 1 diabetes
- Eczema
- Respiratory tract infections
- Childhood cancer
- Sudden infant death syndrome (SIDS)
Benefits for the mother
Breastfeeding offers several health benefits for mothers, including:
- Lower risk of breast, ovarian, endometrial, and thyroid cancer
- Lower risk of osteoporosis, type 2 diabetes, cardiovascular disease, high blood pressure, and high cholesterol
- Quicker recovery from childbirth
- Increased physical and emotional bonding with the baby due to the release of oxytocin, the hormone that helps the uterus contract and reduces vaginal bleeding
Other benefits
In addition to the health advantages, breastfeeding provides economic, psychosocial, and environmental benefits. It saves families the cost of purchasing infant formula and reduces healthcare expenses by lowering the risk of illnesses in both mothers and babies. Breastfeeding also allows mothers to feed their babies anytime, anywhere, without the hassle of preparing bottles or formula.
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Baby-Friendly Hospital Initiative
The Baby-Friendly Hospital Initiative (BFHI) is a global programme launched by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) in 1991. The initiative aims to encourage health facilities worldwide to better support breastfeeding by implementing the Ten Steps to Successful Breastfeeding and the International Code of Marketing of Breast-milk Substitutes.
The BFHI assists hospitals in providing mothers with the information, confidence, and skills necessary to initiate and continue breastfeeding. It also recognises hospitals that have successfully implemented these practices. The initiative emphasises the importance of evidenced-based care, free from commercial interests, where all infant feeding options are possible, and individual preferences are respected. Hospitals are encouraged to educate new mothers about breastfeeding and its benefits, which include reduced risks of certain health conditions for both infants and mothers.
In the United States, Baby-Friendly USA (BFUSA) is the accrediting body and national authority for the BFHI. They work to ensure the widespread adoption of the initiative by refining and upholding standards, assessing and accrediting birthing facilities, and generating understanding of best practices in infant feeding care. Since the BFHI's inception, there has been a significant increase in the number of Baby-Friendly designated facilities, from less than 3% in 2007 to approximately 25% of births in around 600 facilities.
The Ten Steps to Successful Breastfeeding include:
- Complying with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions.
- Having a written infant feeding policy that is communicated to staff and parents.
- Supporting mothers to initiate and maintain breastfeeding and manage common difficulties.
- Not providing breastfed newborns with any food or fluids other than breast milk, unless medically indicated.
- Enabling mothers and their infants to remain together and practice rooming-in 24 hours a day.
- Supporting mothers to recognise and respond to their infants' feeding cues.
- Counselling mothers on the use and risks of feeding bottles, teats, and pacifiers.
- Coordinating discharge to ensure timely access to ongoing support and care for parents and infants.
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Pressures to breastfeed
Breastfeeding has been recognised as the clinical gold standard for infant feeding and nutrition, offering short- and long-term health benefits for both infants and mothers. The World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breastfeeding for about the first six months of an infant's life.
While breastfeeding is widely acknowledged as beneficial, there are pressures associated with it, particularly in hospital settings. In response to declining breastfeeding rates worldwide, the WHO and UNICEF collaborated in 1991 to establish the Baby-Friendly Hospital Initiative (BFHI). This program encourages hospitals and birthing centres to promote breastfeeding through various strategies, including skin-to-skin care and rooming-in policies.
The implementation of the BFHI has led to criticism from some healthcare professionals and mothers. A group of pediatricians and nurses, led by the nonprofit Fed Is Best, argue that the strategies employed by Baby-Friendly hospitals can exert undue pressure on mothers to breastfeed. They claim that the designation may not necessarily improve breastfeeding rates in the first year as intended.
The Baby-Friendly approach often involves ditching formula, nurseries, and pacifiers, which can be challenging for some mothers. For example, Jennifer Bronsnick, a mother of three, found that the hospital's encouragement to exclusively breastfeed and the requirement to keep her newborn with her 24/7 left her feeling overwhelmed and contributed to symptoms of postpartum depression.
Additionally, there may be cultural, social, or medical reasons why some mothers choose not to or cannot breastfeed. Pressuring all mothers to breastfeed without considering their individual circumstances can create unnecessary stress and guilt. It is essential to respect each mother's decision and provide support tailored to their specific needs.
To address these concerns, hospitals should strive to create supportive and safe environments for all mothers, regardless of their feeding choices. This may include providing education and resources for formula feeding when necessary and ensuring that staff is knowledgeable and skilled in supporting a range of infant feeding practices. Ultimately, the goal is to empower mothers to make informed decisions about their infant's feeding and provide the necessary support to achieve their desired feeding goals.
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Breastfeeding difficulties
Breastfeeding is widely considered the healthiest option for both mother and baby. Health experts recommend exclusive breastfeeding for the first six months, followed by breastfeeding as the main source of nutrition for up to two years. However, breastfeeding can present challenges, and it's important to be aware of potential difficulties and know where to seek help.
One of the most common issues is sore and tender nipples, which can be caused by various factors, including improper latching, dry or moist skin, and the baby's sucking action. It is important to address this issue early on by seeking help from a lactation consultant, midwife, or breastfeeding specialist, as they can guide you in finding a comfortable position and ensuring proper latching.
Another challenge is managing milk supply. Some mothers worry about producing enough milk, while others may experience an oversupply or engorgement, which is when the breasts become overly full and painful. Engorgement can interfere with the baby's latch and may lead to a blocked milk duct if left untreated. To manage milk supply, it is crucial to maintain frequent feedings, adequate rest, good nutrition, and proper hydration.
Breastfeeding can also be influenced by physical factors such as breast and nipple size and shape, as well as medical conditions like mastitis, which requires prompt medical attention. Additionally, thrush infections can occur when nipples become cracked or damaged, providing an entry point for the candida fungus. Tongue-tie, a condition where the strip of skin connecting the tongue to the mouth is shorter than usual, can also make breastfeeding more challenging for babies.
Emotional and mental health can also play a role in breastfeeding difficulties. Exhaustion, feelings of sadness or depression, and the constant demands of breastfeeding and newborn care can impact a mother's overall well-being. It is important to remember that every woman's breastfeeding journey is unique, and seeking support from family, friends, and trained professionals is crucial to overcoming these challenges.
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Breastfeeding support
Breastfeeding is widely recognised as the best source of nutrition for infants, offering short- and long-term health benefits. It is associated with a reduced risk of certain health conditions for both infants and mothers. However, the decision to breastfeed is a personal one, and not all mothers choose or are able to breastfeed.
In recognition of the benefits of breastfeeding, hospitals have implemented various initiatives to promote and support breastfeeding among new mothers. One such initiative is the Baby-Friendly Hospital Initiative (BFHI), developed by the World Health Organization (WHO) and UNICEF in 1991. The BFHI outlines ten steps to successful breastfeeding, including skin-to-skin contact between mother and baby, rooming-in (where mother and baby stay in the same room), and eliminating the distribution of formula or pacifiers unless medically necessary.
While the BFHI has been successful in increasing breastfeeding rates, it has also faced criticism. Some mothers have reported feeling pressured to breastfeed and experiencing postpartum depression due to the challenges of exclusive breastfeeding. Additionally, there is mixed research on whether the 'Baby-Friendly' approach is the best method.
To provide effective breastfeeding support, hospitals should ensure that their staff are knowledgeable, competent, and skilled in assisting breastfeeding mothers. This includes educating mothers about breastfeeding, helping them initiate and maintain breastfeeding, and managing common difficulties. Hospitals can also facilitate skin-to-skin contact between mother and baby as soon as possible after birth and encourage rooming-in to support bonding and breastfeeding.
In addition to hospital support, breastfeeding mothers need ongoing assistance from their families, communities, clinicians, and employers. This includes providing places for mothers to pump and store breast milk and offering timely access to ongoing support and care after discharge from the hospital.
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Frequently asked questions
No mother is forced to breastfeed in the hospital. However, it is the clinical gold standard for infant feeding and nutrition, and hospitals are encouraged to promote breastfeeding.
The Baby-Friendly Hospital Initiative is a program developed by the World Health Organization (WHO) and UNICEF in 1991 to encourage hospitals and birthing centres to promote breastfeeding. The initiative includes the "Ten Steps to Successful Breastfeeding", which hospitals can implement to support breastfeeding.
Breast milk is sometimes referred to as "nature's superfood" for babies. Breastfeeding provides short- and long-term health benefits for infants and mothers. Breastfed babies have a lower risk of asthma, allergies, childhood obesity, and gastrointestinal problems. It also reduces the risk of certain health conditions for mothers.
Hospitals that follow the Baby-Friendly Hospital Initiative provide support for mothers who choose to breastfeed, including skin-to-skin care in the first hours of life, rooming-in, and education on breastfeeding and its benefits.
