Recommended
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (14)
Similar to Session 15 assuring that your hospital is supportive of breastfeeding revised 2016
Similar to Session 15 assuring that your hospital is supportive of breastfeeding revised 2016 (20)
Recently uploaded
Recently uploaded (20)
Session 15 assuring that your hospital is supportive of breastfeeding revised 2016
- 1. Assuring That Your Hospital is Supportive of Breastfeeding Session 15 Larry Hogan, Governor Boyd Rutherford, Lt. Governor Van Mitchell, Secretary, DHMH
- 2. Identify barriers and solutions to implementing the steps that comprise the Baby-Friendly Hospital Initiative (BFHI) and the Maryland Hospital Breastfeeding Policy State what Baby-Friendly means State two things you can do or avoid doing at your facility to support breastfeeding Source: United States Breastfeeding Committee
- 3. Hospitals can either help or hinder mothers and babies as they begin to breastfeed BFHI has been shown to increase breastfeeding rates and support mothers by implementing the Ten Steps Hospitals with at least six of the Ten Steps in place have mothers that breastfeed longer CDC Vital Signs August 2011
- 4. Staff must know what Baby-Friendly Certification means In order to obtain Baby-Friendly Certification, all staff must have some general knowledge about the Ten Steps Staff at hospitals seeking Baby-Friendly Certification or recertification could be stopped and asked questions about Baby-Friendly initiatives - it could be you! Source: United States Breastfeeding Committee
- 5. A global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) Encourages and recognizes hospitals that offer an optimal level of care for lactation Source: United States Department of Agriculture (USDA) Source: United States Breastfeeding Committee
- 6. To achieve and maintain certification, a hospital must practice the Ten Steps More than 21,000 hospitals worldwide have achieved Baby-Friendly Certification There are far fewer Baby-Friendly hospitals in the United States Source: United States Breastfeeding Committee
- 8. 1. Have a written breastfeeding policy that is routinely communicated to all health care staff Know where your breastfeeding policy is located Know the content of the policy Know where the 10 Steps are displayed 2. Train all health care staff in skills necessary to implement this policy All staff with mother-baby contact are trained Nurses with direct mother-baby care must receive 20 hours of training, including supervised clinical experience Physicians with maternity/nursery privileges complete 3 hours of education Source: United States Breastfeeding Committee
- 9. 3. Inform all pregnant women about the benefits and management of breastfeeding • Prenatal patients getting care at hospital clinics will receive breastfeeding education through the clinic • All patients will be offered breastfeeding education through the facility or a community program • Education will include benefits of breastfeeding, exclusivity of breastfeeding, and basic management 4. Help mothers initiate breastfeeding within one hour of birth • Babies placed skin-to-skin immediately after birth and should remain so until after completion of the first feeding • During this time, mothers should begin learning feeding cues Source: United States Breastfeeding Committee
- 10. 5. Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants Assess each mother’s breastfeeding techniques and offer assistance with position and latch Inform about expression of milk Teach hand expression to all mothers Provide information about pumping and storage of milk for mothers needing to express milk Provide guidance on formula preparation to mothers who decide not to breastfeed Source: United States Breastfeeding Committee
- 11. 6. Give newborn infants no food or drink other than breast milk, unless medically indicated Staff should discuss mother’s feeding choice and inform about possible consequences of not breastfeeding Materials used by the hospital should be free of messages advertising alternatives to breastmilk 7. Practice rooming-in Allow mothers and infants to remain together 24 hours a day Source: United States Breastfeeding Committee
- 12. 8. Encourage breastfeeding on demand Teach mothers babies’ feeding cues and to feed based on them Encourage no restrictions on feeding frequency or length 9. Give no pacifiers or artificial nipples to breastfeeding infants Mothers shall be educated that use of bottle nipples or pacifiers at this time may interfere with breastfeeding 10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic Provide information to mothers regarding where they can find breastfeeding support after hospital discharge Source: Maryland WIC Program X
- 14. Thank you for your support of breastfeeding mothers and babies Source: B. Wilson-Clay / K. Hoover
- 15. Academy of Breastfeeding Medicine. (2010). Model Breastfeeding Policy. Clinical Protocol #7. Breastfeeding Medicine, Volume 5, Number 4, 2010. http://www.bfmed.org/Resources/Protocols.aspx American Academy of Pediatrics Policy Statement. (2012). Breastfeeding and the use of human milk. Pediatrics, 129, e827-e841. United States Breastfeeding Committee (USBC). (2010). Implementing the Joint Commission Perinatal Care Core Measure on Exclusive Breast Milk Feeding. Revised. Washington, DC: United States Breastfeeding Committee. http://www.usbreastfeeding.org/HealthCareSystem/HospitalMaternityCenterPractices/T oolkitImplementingTJCCoreMeasure/tabid/184/Default.aspx
- 16. U.S. Department of Health and Human Services. (2011). The Surgeon General’s Call to Action to Support Breastfeeding. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General. http://surgeongeneral.gov World Health Organization. (1981). International Code of Marketing of Breast Milk Substitutes (Document WHA34/1981/REC/1, Annex 3). Geneva, Switzerland: World Health Organization. World Health Organization/UNICEF. (2009). Baby Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care. World Health Organization, UNICEF. http://www.unicef.org/newsline/tenstps.htm
Editor's Notes
- Read title and subtitle
- BBC 12: Sustainability
- You have now received a lot of information about how you can help a breastfeeding family as they learn to breastfeed. Studies have shown that early post-birth management of mother-infant care influences the dyads success in reaching breastfeeding goals. The steps discussed, which we will review during this module, have been shown through evidence-based research to improve breastfeeding outcomes. It has further been shown that even fulfilling just six of the 10 steps improves breastfeeding success rates of your patients.
- Hospitals achieving Baby Friendly Certification are audited to assure that all staff are following the steps that support breastfeeding families. During the audit, any hospital employees could be asked questions regarding the meaning and importance of Baby Friendly and its components. After achieving certification, audits continue to occur to maintain the Baby Friendly status.
- Not every hospital is certified Baby Friendly. Those certified have achieved a level of breastfeeding support that is recognized world-wide as the optimum level of mother-baby care with regard to infant feeding.
- Hospitals that show they are fulfilling the 10 steps are able to obtain the Baby Friendly certification. In 2014, more than 21,000 hospitals have already achieved this certification world-wide. Unfortunately, the United States is lagging behind, with less than 200 hospitals nationally and few achieving this status in Maryland. By following the Maryland Hospital Breastfeeding Policy, all hospitals in Maryland will be one step closer in supporting breastfeeding and improving breastfeeding outcomes. Look into the Baby Friendly information to see how these numbers have changed by the time you are viewing this presentation.
- Let’s take a look at the 10 steps, focusing on what an auditor might look for.
- We have already focused on the 10 steps, however it is important to know what auditors will be looking for. Be sure you know where your hospital’s breastfeeding policy is located, what is included, and where the 10 steps are displayed for the public. Understand that training is provided to all staff who encounter mothers and babies, yet the amount of training varies depending on responsibilities. Obviously, primary care nurses working in areas such as maternity and pediatric units will need to complete the most detailed training, which equals at least 20 hours. Included in this training should be at least 5 hours of clinical experience. Some facilities may choose to provide this level of training to other staff, such as nursing techs or aides who may also be working closely with mothers and babies. Physicians on staff at the hospital will need to complete at least 3 hours of breastfeeding education.
- Families make feeding choices prenatally, so it’s important that they receive information at that time in order to make informed decisions. Baby Friendly facilities must provide this information through hospital-based prenatal clinics and have at least one source to offer for patients receiving care through non-affiliated prenatal practices. Education provided must include, at minimum, information about the benefits of breastfeeding, the importance of exclusive breastfeeding for the first 6 months, and basic breastfeeding management practices. Step four focuses on getting the baby started immediately following birth. Babies should be placed skin-to-skin within 5 minutes of birth or as soon as mothers delivering by C-section are able to respond. Babies are to be left skin-to-skin, uninterrupted, until the completion of the first feeding. For those who have chosen not to breastfeed, babies should be left skin-to-skin for one hour.
- Earlier modules covered how to assist breastfeeding dyads. It is important that all mothers are shown how to position and latch their babies. Assistance should be provided as needed. Mothers should also be taught hand expression, in case needed in the future to resolve a breastfeeding issue or extract milk. Those with infants who are unable to fully nurse at the breast should be provided information and support regarding pumping and milk storage. Finally, mothers who have decided not to breastfeed should be individually educated about proper mixing and storage of infant formula.
- It is important that supplements to breastfeeding, which the evidence shows can prevent breastfeeding success, are given only if medically indicated. Of course, there will be times when mothers decide to do so without medical indication. Those feeding decisions should be discussed and they must be informed about potential consequences of doing so. Their choice, after being informed, should then be documented. Any hospital materials given to families or displayed should be free of formula company advertising or suggestions that promote infant food or drink other than breast milk. Company logos and names remind the public of the products they represent and imply healthcare endorsement, so they should also be avoided. Mothers and babies should room-in together, regardless of feeding preferences. Procedures, when able should be done at bedside. Separation of up to one hour per day for medical procedures is also allowed, if unable to be performed in the hospital room.
- Feeding cues should be pointed out to mothers. Mothers should be taught to begin and end feedings based on their infants’ feeding cues. Early use of bottle or pacifier nipples can interfere with breastfeeding. Encouraging mothers not to use these and to let the infant practice and perfect how to suckle on the breast will promote the best breastfeeding outcomes. If supplements are needed, it is encouraged that they be given by tube, syringe, spoon, or cup rather than an artificial nipple,+ because these methods do not interfere with the infants’ ability to learn to breastfeed. Check your hospital policies to see which alternative feeding methods are used at your facility. Learning to breastfeed takes more than the few days mothers and babies are hospitalized. It is imperative that mothers be told where they can get support once home. Some hospitals have their own breastfeeding support groups while others refer mothers to community based breastfeeding groups, local Women’s, Infants, and Children’s Programs (WIC) or other breastfeeding support services. Check to see what breastfeeding support is available for referral in your community. It is best that mothers receive additional breastfeeding support within 48 hours of hospital discharge.
- BBC 12: Sustainability
- BBC 12: Sustainability