Baby-Friendly Hospital Initiative

Quality of Life Families save between $1200 & $1500 in formula alone in the first year Fewer missed days of work due to sick babies Babies have higher IQs If 90% of U.S. families followed guidelines to exclusively breastfeed for 6 months, U.S. would annually save $13 billion

Healthiest Community Babies are less likely to have ear infections, pneumonia, diarrhea, asthma, obesity, diabetes, Sudden Infant Death Syndrome, NEC and RSV. Mothers reduce their risk of breast and ovarian cancers.

Breastfeeding Personal Preference Scientific Value

here are multiple very real advantages to providing human milk There are multiple very real advantages to providing human milk (for both mom and baby) Hundreds of scientific papers have been published on this topic Human milk is superior to formulaHuman milk is superior to formula Formula is inferior to human milkFormula is inferior to human milk

Benefits of Human Milk: Mortality Post-neonatal infant mortality rates in the United States are reduced by 21% in breastfed infants Pediatrics Feb;115(2):

Benefits of Human Milk: Summary Human milk is the recommended source of nutrition for preterm and term newborns Human milk has a large number of health benefits for babies, mothers, and society Human milk is an extremely important MEDICATION that should be used in every newborn!!!

The Surgeon General’s Call to Action to Support Breastfeeding 2011 “Nearly all births in the United States occur in the hospital, but hospital practices and policies in maternity settings can create barriers to supporting a mother’s decision to breastfeed.” The Surgeon General’s Solution? Become Baby-Friendly

What are hospitals doing to undermine breastfeeding success? Failure to put babies skin to skin with their mothers immediately after birth Supplementing full-term, healthy newborns with formula Providing gift packs from formula companies Separating mothers and their babies during the postpartum stay “…the tragedy is that despite knowledge about the negative effects…these practices continue in many U.S. hospitals.” –Nancy K. Lowe, Editor, JOGNN 2011

Maternal Infant and Child Health: Goal #24 Increase the proportion of live births that occur at facilities that provide the recommended care for lactating mothers and their babies “Recommended care” = Baby-Friendly

“What can be done? Become Baby-Friendly.”

CDC Breastfeeding Report Card 2011 “…less than 5% of U.S. infants are born in Baby- Friendly hospitals. The hospital period is critical for mothers and babies to learn to breastfeed, and hospitals need to do more to support them.”

PC-01 Elective delivery PC-02 Cesarean section PC-03 Antenatal steroids PC-04 Health care–associated bloodstream infections in newborns PC-05 Exclusive breast milk feeding PC-05 How? Baby-Friendly

Retail cost of formula based on 2010 usage $208, Estimated wholesale cost estimated between $27, and $41, Cost cutting measures Increase exclusive breastfeeding rates Decrease gratuitous use of formula Control access to formula Track formula usage Absorb costs through room charge adjustment Supply usage analysis

Funding Health Foundation Local business grants American Academy of Pediatrics grants Center for Disease Control grants Indiana Perinatal Network

The Beginning!

10 Steps to Baby-Friendly Have a written breastfeeding policy that is routinely communicated to all healthcare staff. Train all health care staff in skills necessary to implement this policy. Inform all pregnant women about the benefits and management of breastfeeding. Help mothers initiate breastfeeding within one hour of birth. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants.

10 Steps to Baby-Friendly Give newborn infants no food or drink other than breastmilk, unless medically indicated. Practice rooming-in—allow mothers and infants to remain together 24 hours a day. Encourage breastfeeding on demand. Give no artificial nipples or pacifiers to breastfeeding infants. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic.