You might think all hospitals should be baby-friendly, but to be officially recognized as part of the World Health Organization/UNICEF “Baby-Friendly Hospital Initiative,” a maternity facility has to meet certain standards. In 2018, more than 25 percent of births in the U.S. occurred in Baby-Friendly hospitals, of which there are more than 500 nationwide.
“Baby-Friendly hospitals are committed to supporting best practices for nursing mothers and breastfeeding babies,” Dr. Melanie Mouzoon, a pediatrician at The Woman’s Hospital of Texas- HCA Houston Healthcare, tells SheKnows. “That includes the 10 steps to successful breastfeeding, which are evidence-based interventions that have been associated with longer duration and more exclusivity in breastfeeding.”
But what do Baby-Friendly hospitals do that all hospitals should?
1. Help normalize breastfeeding
All Baby-Friendly hospitals have a policy that supports breastfeeding, starting with making sure moms know breastfeeding is best for their baby. The WHO recommends exclusive breastfeeding until the baby is 6-months-old and continued breastfeeding alongside appropriate complementary foods up to the age of 2 years or beyond. Doctors and nurses in Baby-Friendly hospitals are educated on how to best help new moms deal with common breastfeeding issues and make an informed decision about feeding their babies. “Proper education can help dispel the common myths about breastfeeding and help moms get an effective latch,” explains Mouzoon.
Baby-Friendly hospitals encourage breastfeeding within an hour of birth — unless the mom or baby is critically ill — through skin-to-skin contact. This happens whether it’s a vaginal or C-section delivery and before any unnecessary interventions, such as weighing the baby, take place. “Initial skin-to-skin contact is shown to correlate with the baby subsequently taking to the breast much easier and doesn’t interfere with their instinctive desire to nurse after birth,” says Mouzoon.
Mouzoon recognizes that, predominantly, Western culture doesn’t support breastfeeding, which can affect how some moms feel about and approach the practice. Essentially, this is what the “Baby-Friendly Hospital Initiative” is trying to change. “We don’t see babies being breastfed. We don’t watch our mothers breastfeed. We don’t know what it’s supposed to look like, and we really don’t know how to do it,” says Mouzoon. “As kids, we fed our baby dolls formula out of little baby bottles that came with the baby doll.”
2. Dispel breastfeeding myths
The fact that breastfeeding isn’t seen as “normal” is harmful, adds Mouzoon, because it leads to many misconceptions, which may prevent a mom from breastfeeding or lead her to stop breastfeeding shortly after birth. “The biggest problems I see are that mothers think breastfeeding is going to hurt or they believe they’re holding the baby properly,” says Mouzoon. “In fact, they just need a little adjustment to make breastfeeding comfortable — and pain-free — and much more effective for the baby.”
A common myth — that breastfeeding is supposed to hurt — can and should be dispelled with better education. “Moms should feel a tugging sensation, but no biting or pinching,” Mouzoon says. “And it definitely shouldn’t cause abrasions, cracking, fissures or nipple trauma. Pain is a feedback mechanism to the mom to say she’s not getting it right and needs to ask for help. Unfortunately, as a society, we don’t have a lot of people who know what that help entails and how to offer it.”
3. Help moms (& their babies) get a strong latch
In a Baby-Friendly hospital, moms get multilayered breastfeeding help right after birth. Initially, nurses — who’ve had 20 hours of breastfeeding education, including five hours working with a lactation consultant — assist moms with latching, support their initial breastfeeding attempts and help them learn their babies’ cues.
Breastfeeding consultants are also on hand to provide more detailed support, such as checking the baby for tongue tie and helping moms deal with other issues that affect latch, such as when the baby has Down syndrome.
A strong latch starts with the right position, says Mouzoon. She uses the “drinking from the bowl” analogy with moms to help with positioning — the baby needs to be fully facing the breast with one hand on either side, their chin on the chest and mouth open wide like a yawn.
4. Provide a broader breastfeeding education
Breastfeeding education in Baby-Friendly hospitals goes beyond latch and positioning tips. The comprehensive education the nurses and doctors receive allows them to help new moms gain a deeper understanding of the entire lactation process. “Most moms are not aware that babies come out waterlogged and don’t need large volumes of milk right away,” says Mouzoon. “Our bodies don’t make milk until three to five days postpartum, and until then, we only produce a very small volume of colostrum (the thick, yellowish “first milk” that has high concentrations of antibodies and nutrients).”
Colostrum is all that baby needs in the first few days, but it’s harder to get out of the breast, so they might have to work a little harder, resulting in frequent nursing. “This can make moms panic that their baby isn’t getting enough milk, which may make them turn to formula, says Mouzoon. “However, babies are rarely medically indicated to need formula in the first few days.”
5. Help moms access further help
Mouzoon acknowledges that when moms leave the hospital, they often struggle to continue breastfeeding due to a lack of support. A key part of the “Baby-Friendly Hospital Initiative” is to ensure moms know how and where to access breastfeeding support groups to get help after they’ve been discharged. “If moms go home and have problems, such as engorgement or latching problems, they don’t know what to do and often give up just at the point where breastfeeding is about to be successful,” she says.
6. Support every mom, whatever she decides
Despite the focus on promoting breastfeeding, moms who choose to give their babies formula are supported too. “Skin-to-skin is a bonding experience as well as a feeding experience,” explains Mouzoon. “It provides the baby with the proper germs to colonize their body and keeps them warm. If the baby latches on at that point, they will benefit from the colostrum.”
Mouzoon hopes some moms at this stage will change their minds about breastfeeding, but there’s no pressure on them to do so, and staff will support any mom’s decision to formula-feed, teaching her how to safely prepare and properly mix formula and feed her baby with a bottle.
There’s no doubt being a new mom can be confusing, exhausting and stressful, and feeding a newborn — however you choose to do it — is one of the most challenging parts of the experience. If you think a Baby-Friendly hospital would help make your transition to parenthood a little easier, you can find your nearest one here.
This post was created by SheKnows for The Woman’s Hospital of Texas- HCA Houston Healthcare.