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Bosom buddies Labor & Delivery

Bosom buddies

Hospitals around the globe are becoming officially “Baby-Friendly” by putting breastfeeding first. Does your facility meet the criteria?

When I was expecting my first child in 2007, I attended a crash course in breastfeeding at the local hospital where I planned to deliver. I heard all about how important it was to breastfeed, how the practice would benefit my baby in so many ways. Paradoxically, the hospital also had a sign-up sheet, so everyone could register with the big-name formula retailers. I filled out my contact information (everyone did, really) and subsequently received formula coupons and samples—at my doctor’s office and in my mailbox—from competing companies each claiming to be the best substitute for breast milk, if a substitute were needed.

When my baby was born that April, a lactation consultant stopped by my hospital room to discuss the merits of breastfeeding, explain various breastfeeding positions and help me to obtain the proper latch. But when my baby girl was taken to the nursery that evening, the nurse on duty casually asked which brand of formula I would like them to give her during the night.

Say what? The conflicting viewpoints of “breast is best” and “but really, which formula do you use?” left me slightly disoriented. My experiences were not uncommon by any means, but they wouldn’t have played out the same way in a Baby-Friendly hospital.

What is a “Baby-Friendly” hospital?
In 1991, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI). The BFHI encourages hospitals and birthing centers around the globe to earn the “Baby-Friendly” designation by adopting standards that support breastfeeding 100 percent. In the United States, Baby-Friendly USA, Inc. is tasked with helping facilities earn Baby-Friendly accreditation. Baby-Friendly USA, Inc. states, “In order to receive a Baby-Friendly designation, birthing facilities must implement the Ten Steps to Successful Breastfeeding and comply with the International Code of Marketing of Breast-Milk Substitutes.”

The Ten Steps include breastfeeding supports such as teaching moms how to breastfeed and maintain lactation, practicing “rooming in”—where moms and babies are kept together 24 hours a day rather than separated by time in a nursery, and withholding pacifiers and breast milk substitutes. Every one of the Ten Steps is meant to provide consistent support for breastfeeding. (Click here for the full list.)

The International Code of Marketing for Breast-Milk Substitutes has to do with formula introduction and distribution. A Baby-Friendly facility will not send mom home with formula samples or formula-promoting marketing materials. The code does recognize the importance of formula as a breast milk substitute when it’s medically necessary, but it calls for squelched marketing to the general public so that breastfeeding can receive more emphasis and support.

Is “Baby-Friendly” a must for expectant moms?
While the number of Baby-Friendly facilities is growing every year, the majority of U.S. facilities don’t carry the designation yet. If you’ve chosen to deliver at a hospital or birth center that’s not on the Baby-Friendly list, does it mean you’ll have a terrible birth experience? Or that your breastfeeding efforts are doomed to fail? Absolutely not. The absence of a Baby-Friendly designation says nothing about the quality of care at that hospital or birth center. In fact, the staff and facilities may be quite outstanding.

On the other hand, when a hospital or birth center is designated Baby-Friendly, you know that you can count on them to support breastfeeding from every angle. And the implication goes further than simply meeting the criteria on a check-list. A Baby-Friendly facility has put significant time and effort into pursuing the designation—it has painstakingly documented every step, trained each staff member, passed several interviews and opened its doors for evaluation to prove that it is supporting breastfeeding in every advisable way. More than anything, “Baby-Friendly” says here is a facility that cares. It’s important to them to maintain a reputation of excellent mother-child care, and they’ll do everything within their power to encourage effective breastfeeding.

How to have a successful start, “Baby-Friendly” or not
If your doctor or midwife delivers at a Baby-Friendly facility, you’re in luck! If not, you have the choice to switch to a doctor who does. Of course, this isn’t always practical. If you’re very far into your 40 weeks, switching care providers might not be a prudent decision. Or maybe there isn’t a Baby-Friendly hospital close to you or in sync with your insurance plan. Don’t sweat it.

No matter where you deliver, you can simulate a Baby-Friendly experience—if you so choose—by adhering to the same Ten Steps to Successful Breastfeeding registered facilities are required to follow. For example, let your nurse know that you want baby to room in with you at the hospital. Don’t allow anyone to offer baby a pacifier or bottle. Ask to meet with a lactation specialist. (Many hospitals keep one on staff.) Team up with a local breastfeeding support group. (Visit La Leche League at to find meetings near you.)

It will take some effort on your part, but the Baby-Friendly experience can be within your reach, and your endeavors are bound to put you on the path toward breastfeeding success.