October 2, 1998 

On the road to becoming a Baby-Friendly Hospital

The MGH recently received a certificate of intent to become a Baby-Friendly Hospital, part of a worldwide effort to encourage, promote and support breastfeeding in maternity hospitals. This effort, called the Baby-Friendly Hospital Initiative, is sponsored by the World Health Organization and the United Nations Children's Fund (UNICEF). In the United States, these efforts are coordinated by a nonprofit organization called Baby-Friendly USA. Globally, 13,000 hospitals have become Baby-Friendly. If selected, the MGH will become one of only 13 hospitals in the United States to be certified.

According to Lisa Stellwagen, MD, of MGH Newborn Services, the certificate of intent represents the first step in the process of becoming a Baby-Friendly Hospital. Because the MGH has a longstanding commitment to promoting breastfeeding as the preferred method of infant nutrition, applying to become a Baby-Friendly Hospital was a natural fit for the hospital's mission. To accomplish this goal, the hospital will be implementing Baby-Friendly USA's 10-step program that has been shown to successfully support breastfeeding of healthy full-term infants:

The 10 steps to becoming a Baby-Friendly Hospital:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.

2. Train all health care staff in skills necessary to implement this policy.

3. Inform all pregnant women about the benefits and management of breastfeeding.

4. Help mothers initiate breastfeeding within one hour of birth.

5. Show mothers how to breastfeed and how to maintain lactation, even if they should be separated from their infants.

6. Give newborn infants no food or drink other than breast milk, unless medically indicated.

7. Practice rooming-in, allowing mothers and infants to remain together 24 hours a day.

8. Encourage breastfeeding on demand.

9. Give no artificial nipples or pacifiers to breastfeeding infants.

10. Foster the establishment of breastfeeding support groups and refer mothers to them once discharged from the hospital or clinic.

To address the needs of breastfeeding mothers and to improve breastfeeding rates, the MGH has established a multidisciplinary breastfeeding task force. The current rate of breastfeeding at the time of discharge from the MGH Maternity Unit is 78 percent. By the six-week postpartum visit, however, less than 20 percent of women are still breastfeeding.

"Breast milk is the perfect nutrition for babies," says Stellwagen. "The medical benefits of exclusive breastfeeding are so impressive that I feel we need to do everything we can to support and encourage women to breastfeed their infants. This program has been very successful in other countries. There are some barriers to implementing this program in a large academic hospital, but we are excited about the program and committed to its success."