Tessa Quinn
Breastfeeding is the clinical gold standard for infant feeding and nutrition. It has been shown to have a protective effect against various health issues, including gastrointestinal infections, among other benefits. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of a baby's life. However, exclusive breastfeeding rates remain low globally, and various factors can hinder a mother's ability and willingness to breastfeed. Hospitals play a crucial role in promoting breastfeeding by implementing initiatives that support and encourage new mothers to initiate and maintain breastfeeding. This includes providing education, counselling, and practical support to mothers and their families, facilitating skin-to-skin contact, and enabling rooming-in for mothers and infants.
| Characteristics | Values |
|---|---|
| Global standards | WHO's Ten Steps to Successful Breastfeeding |
| Hospital initiatives | Baby-Friendly Hospital Initiative |
| Support | Ongoing support, advice, and reassurance |
| Skin-to-skin contact | Facilitate immediate and uninterrupted skin-to-skin contact |
| Rooming-in | Enable mothers and their infants to remain together and to practice rooming-in 24 hours a day |
| Education | Educate new mothers about breastfeeding |
| Counseling | Trained breastfeeding counselor |
| Training materials | WHO and UNICEF training materials |
| Breast milk banks | Collected, pasteurized, and frozen breast milk |
| Community support | Peer counseling and supplemental nutrition programs |
| Maternity leave | Flexible work hours and maternity leave benefits |
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What You'll Learn
Encourage skin-to-skin contact and rooming-in
Skin-to-skin contact and rooming-in are important practices that hospitals should promote to encourage breastfeeding. Skin-to-skin contact is when a baby is dried and laid directly on the mother's bare chest after birth, with both covered in a warm blanket for at least an hour or until after the first feed. This practice can also be done whenever a baby needs comforting. It helps regulate the baby's heart rate, breathing, and temperature, and stimulates the release of hormones that support breastfeeding and mothering. It also enables the colonisation of the baby's skin with the mother's friendly bacteria, providing protection against infection.
The World Health Organization (WHO) recommends skin-to-skin contact and exclusive breastfeeding as crucial components of Early Essential Newborn Care (EENC). Hospitals can support this by providing uninterrupted skin-to-skin contact for at least 90 minutes in delivery and postnatal rooms. This has shown to improve breastfeeding initiation, with 90% of full-term babies able to breastfeed exclusively.
Skin-to-skin contact is also a vital component of 'Kangaroo Mother Care', especially for premature or low-birth-weight babies. This method helps regulate the baby's heart rate, temperature, and blood sugar levels, and triggers instincts that make feeding easier and more natural. It also helps the baby indicate when they are ready to feed and increases the likelihood of attachment to the breast.
Rooming-in, or having the baby stay in the same room as the mother for 24 hours a day, is another important practice that hospitals should promote. This allows the mother to identify the infant's feeding cues and nurse longer and more often, which are key behaviours for breastfeeding success. It is associated with higher breastfeeding rates for at least six months postpartum and has additional benefits such as improved patient satisfaction and increased infant security.
To ensure the safety of both mother and baby during skin-to-skin contact and rooming-in, hospitals should provide close observation and prompt removal of the baby if any health concerns arise.
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Educate new mothers about breastfeeding
Breastfeeding has numerous benefits for both the mother and the baby, and hospitals play a crucial role in promoting and supporting this practice. The World Health Organization (WHO) and UNICEF have jointly launched the Baby-Friendly Hospital Initiative (BFHI) to encourage hospitals to implement the Ten Steps to Successful Breastfeeding. These steps provide guidance on policies and procedures to support breastfeeding mothers.
One of the key steps is to educate pregnant women and their families about the importance and management of breastfeeding. Hospitals should facilitate discussions and counselling sessions to inform mothers about the advantages of breastfeeding, including health and economic benefits. For example, breastfeeding lowers the rate of breast and ovarian cancer in mothers, promotes faster weight loss, and strengthens the emotional bond between mother and child. It also reduces the risk of childhood infections and chronic diseases, boosts IQ, and increases earning potential. Additionally, breastfeeding is more convenient than formula feeding as it requires no preparation, is always ready and available, and is always at the ideal temperature.
Hospitals should also address any questions or concerns that mothers may have. For instance, some mothers may be unaware that it is normal for a baby to lose weight in the first few days after birth, regardless of feeding method. Educating mothers about such topics can help dispel misconceptions and empower them to make informed decisions. It is also essential to respect a mother's decision if she chooses not to breastfeed and provide support for safe replacement feeding if necessary.
Furthermore, hospitals can educate mothers about practical aspects of breastfeeding, such as recognizing and responding to their infants' feeding cues and the importance of skin-to-skin contact immediately after birth. This includes placing the baby on the mother's upper abdomen or chest, preferably within the first hour after birth, and encouraging the baby to latch on when it starts "rooting" or searching for the breast. Hospitals can also provide guidance on the use and risks associated with feeding bottles, teats, and pacifiers.
By implementing these educational measures, hospitals can effectively promote breastfeeding and ensure that new mothers feel informed, supported, and empowered to make the best choices for themselves and their infants.
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Provide ongoing support and care
Providing ongoing support and care is essential to promoting successful breastfeeding in hospitals. This involves offering advice, reassurance, and assistance to new mothers as they navigate the challenges of breastfeeding. Here are some key aspects of providing ongoing support and care:
Skin-to-skin Contact and Rooming-in:
Encouraging skin-to-skin contact between the mother and baby immediately after birth is crucial. This promotes a feeling of closeness and a strong hormonal response linked to breastfeeding success. Hospitals should facilitate uninterrupted skin-to-skin contact and allow mothers and infants to room-in together 24 hours a day. This helps establish breastfeeding and enhances the emotional bond between them.
Counselling and Support Groups:
Breastfeeding counselling services, both in-hospital and through home visits or telephone support, can provide new mothers with valuable guidance and emotional support. Counsellors can address concerns, offer advice on techniques, and normalise challenges. Additionally, support groups, including peer counselling and community-based groups, can offer ongoing encouragement and a sense of community for mothers.
Education and Information:
Educational interventions and classes can empower mothers by providing information about the benefits of breastfeeding for both mother and child. Hospitals can also educate new mothers about proper breastfeeding techniques, common difficulties, and the importance of exclusive breastfeeding for the first six months. This knowledge can help mothers make informed decisions and improve their breastfeeding success.
Family Involvement:
Involving the family, including fathers and other support persons, can enhance ongoing support for breastfeeding mothers. Educating and counselling family members can help them understand the importance of breastfeeding and how they can assist the new mother. This can lead to a more supportive environment for breastfeeding and improve the overall success rate.
Community and Workplace Support:
Support for breastfeeding mothers should extend beyond the hospital and into their communities and workplaces. Hospitals can partner with community organisations to provide peer counselling, supplemental nutrition programs, and other resources. Additionally, employers can be encouraged to support breastfeeding mothers by providing flexible work hours, designated spaces for pumping and storing breast milk, and maternity leave benefits.
By implementing these measures, hospitals can provide comprehensive ongoing support and care, contributing to higher breastfeeding initiation and continuation rates, ultimately improving the health and well-being of both mothers and infants.
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Promote the Baby-Friendly Hospital Initiative
The World Health Organization (WHO) and UNICEF launched the Baby-Friendly Hospital Initiative (BFHI) to encourage health facilities worldwide to better support breastfeeding. The initiative is based on the following Ten Steps to Successful Breastfeeding, which summarize a package of policies and procedures that hospitals should implement to promote optimal clinical care for new mothers and their infants:
Comply with the International Code of Marketing of Breast-milk Substitutes
Hospitals should fully comply with the International Code of Marketing of Breast-milk Substitutes and relevant World Health Assembly resolutions. This includes eliminating the exposure of the general public to the marketing of breast-milk substitutes and inappropriate promotion of foods for infants and young children.
Have a written infant feeding policy
Hospitals should have a written infant feeding policy that is routinely communicated to staff and parents. This policy should include information on the advantages of breastfeeding, such as health and economic benefits, as well as the risks of not breastfeeding.
Discuss the importance and management of breastfeeding with pregnant women and their families
It is important to provide information and support to pregnant women and their families to help them understand the importance of breastfeeding and how to manage it. This includes providing reassurance and addressing any questions or concerns they may have.
Facilitate immediate and uninterrupted skin-to-skin contact
Hospitals should support mothers to initiate skin-to-skin contact and breastfeeding as soon as possible after birth. This is important for promoting emotional bonding between mother and infant.
Support mothers to initiate and maintain breastfeeding
Mothers should be supported to initiate and maintain breastfeeding and manage common difficulties. This includes providing ongoing support, advice, and reassurance, and referring women to trained breastfeeding counsellors or support materials if necessary.
Do not provide breastfed newborns any food or fluids other than breast milk
Breastfed newborns should not be given any food or fluids other than breast milk, unless medically indicated. This helps to ensure exclusive breastfeeding and optimal nutrition for the baby.
Enable mothers and their infants to remain together
Hospitals should enable mothers and their infants to remain together and practice rooming-in 24 hours a day. This allows mothers to feed their babies on demand and respond to their cues for feeding.
Support mothers to recognize and respond to their infants' cues for feeding
It is important to educate mothers about the importance of responding to their infants' feeding cues and how to do so. This includes understanding that it is normal for a baby to lose weight in the first few days after birth.
Counsel mothers on the use and risks of feeding bottles, teats, and pacifiers
Mothers should be counselled on the use and risks of feeding bottles, teats, and pacifiers, including the impact of these on breastfeeding and the potential for improper use to cause dental issues.
Coordinate discharge and provide ongoing support
Hospitals should coordinate discharge so that parents and their infants have timely access to ongoing support and care. This includes ensuring that mothers have the necessary resources and referrals to continue breastfeeding successfully once they return home.
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Counsel and reassure mothers
Counselling and reassurance are key to helping mothers breastfeed successfully. Women may need extra support and encouragement as they learn this skill. Breastfeeding has a range of benefits for both mother and baby, and these should be communicated to mothers so they can make an informed decision about feeding their baby. For example, breastfeeding lowers the rate of breast and ovarian cancer in the mother, promotes a faster return to the mother's pre-pregnancy weight, and promotes emotional bonding between mother and infant. It is also easier to carry out than formula feeding, as it requires no preparation, is always at the correct temperature, and is always clean and available.
Mothers should be counselled on the use and risks of feeding bottles, teats, and pacifiers, as introducing these can cause the baby to breastfeed less, and the mother's breast milk supply will decrease. Mothers should also be reassured that it is normal for a baby to lose weight in the first three or four days after birth, and that this is not a reflection of how she is breastfeeding. Mothers of low birth-weight or preterm babies should be counselled that their babies may get easily tired when feeding, and that they should feed their babies as often as possible, responding to demand, with at least eight feeds in 24 hours.
Mothers should be supported and reassured that they are making the right choice for themselves and their babies. Breastfeeding has been shown to have a protective effect against gastrointestinal infections, and globally, exclusive and continued breastfeeding could help prevent 13% of deaths among children under five years old. Breastfed children have fewer childhood infections, fewer chronic diseases, 3–5 extra points of IQ, higher earning potential, more opportunities to prioritise education, and healthier mothers.
Counselling can take many forms, including in-person, telephone, and internet or software-based. In-hospital counselling is an important way to support mothers, as is follow-up counselling during home visits. Counselling can also involve fathers, as well as peer support groups.
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Frequently asked questions
Hospitals can promote breastfeeding by implementing the Ten Steps to Successful Breastfeeding, a global standard to promote breastfeeding. This includes facilitating immediate and uninterrupted skin-to-skin contact, supporting mothers to initiate breastfeeding as soon as possible after birth, and providing education and counselling to new mothers about breastfeeding and its benefits.
Breastfeeding has numerous benefits for both the mother and the baby. For the baby, breast milk is the perfect nutrition, providing protection against gastrointestinal infections, Sudden Infant Death Syndrome (SIDS), and other diseases. Breastfed children also tend to have higher IQs and earning potentials. For mothers, breastfeeding lowers the risk of breast and ovarian cancer and promotes a faster return to their pre-pregnancy weight.
Hospitals can improve breastfeeding success rates by keeping mothers and babies together after birth, enabling skin-to-skin contact, and providing ongoing support, advice, and reassurance to new mothers. Hospitals can also refer mothers to trained breastfeeding counsellors or support groups and provide access to resources such as breast milk banks.
The World Health Organization (WHO) and UNICEF have launched the Baby-Friendly Hospital Initiative (BFHI) to encourage hospitals to implement the Ten Steps to Successful Breastfeeding. Additionally, the WHO provides guidance to member states on eliminating the marketing of breast-milk substitutes and inappropriate infant foods and works with partners to promote maternity protection and community support for breastfeeding mothers.
