By Megan M. Krischke, contributor
Creating hospital environments that promote, protect and support breastfeeding is the main goal of the Baby-Friendly Hospital Initiative (BFHI), which is co-sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). Evergreen Hospital in Kirkland, Washington, was the first U.S. hospital to receive its Baby-Friendly certification back in 1996. Today Evergreen enjoys a 96 percent breastfeeding initiation rate among its mother-baby pairs.
“In the mid-1980s, Evergreen had some really progressive folks who were looking at the care we were giving and asking, ‘Is this the best we could be doing for people?,’ ‘Why are we separating babies from mothers?,’ and ‘Why are we bringing babies to mothers on a schedule instead of when they are hungry?,’" explained Jeanne Schneider, RN, IBCLC, charge nurse of the post-partum outpatient clinics at Evergreen.
“They moved to single-room, family-centered care, which meant that mothers labored, delivered and recovered all in the same room, and healthy babies were not separated from their parents. That was a pretty visionary idea at the time,” she continued
To further their efforts toward family-centered care, Evergreen hired renowned lactation consultant, Molly Pessl, RN, BSN, IBCLC. It was Pessl who led the way toward Evergreen becoming designated as a Baby-Friendly Hospital.
“When UNICEF/WHO was looking to bring BFHI to the U.S., Evergreen was a prime candidate, both because of Pessl’s experience and because the hospital was already practicing some of the ‘Ten Steps,’” Schneider remarked, referring to BFHI’s Ten Steps to Successful Breastfeeding for Hospitals (see inset).
One of the biggest challenges for Evergreen in becoming a Baby-Friendly facility was determining how to pay for staff training and for formula. Many other institutions face the same challenge.
In order to achieve Baby-Friendly status, all maternity staff at the candidate hospital are required to participate in an 18-hour training program. Additionally, the hospital is not allowed to accept free formula, which can be viewed initially as a sizable financial burden by institutions in areas with lower breastfeeding initiation rates. As the BFHI elevates breastfeeding initiation rates, the cost of formula decreases substantially.
Despite these challenges, Schneider, who also played a role in Evergreen becoming a Baby-Friendly facility, believes the program significantly benefits patients, staff and the hospital.
“People come to Evergreen to have their babies because of the reassurance that there is a level of expertise. If I was expecting a baby, I would choose a Baby-Friendly Hospital because the staff has demonstrated in a formal way that they practice the ‘Ten Steps,’ and I know they will not put obstacles in my way as I am learning to feed my baby,” explained Schneider.
“From a staff point of view we have consistency in our practices and in what we are teaching parents. Being told different things by different professionals is perplexing and frustrating for new parents,” she continued. “Our staff knows the evidence behind why they are doing what they are doing.
“Finally, from the hospital’s point of view, certification is a good way to market this part of our service; to let our community know that when they have a baby here, we know how to support and protect breastfeeding. And because certification requires renewal every five years, the BFHI provides continual quality assurance and ensures that we are doing the best things for our patients all the time.”
Schneider concluded, “The bottom line is that the BFHI is the best practice for the health of mothers and babies, and what we want are healthy mothers and healthy babies.”
As of May 2009, 80 U.S. hospitals and birth centers have earned the Baby-Friendly designation. For more information, visit the BFHI web site.
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