What is a Baby Friendly Hospital?

At Motherlove, we strongly support the Baby Friendly Hospital Initiative.  We think that every expecting mom who is planning a hospital birth should know about Baby Friendly Hospitals, so we thought we’d answer a few common questions here:

What is a Baby Friendly Hospital?

The Baby-Friendly Hospital Initiative is a program sponsored by the World Health Organization and UNICEF to encourage and recognize hospitals that provide evidence-based breastfeeding care.

A Baby Friendly Hospital is one which has been certified as fully complying with the Ten Steps to Successful Breastfeeding.  To become Baby Friendly, hospitals undergo a lengthy certification process and an independent evaluation to determine that they have met all of the Baby Friendly criteria.


What are the Ten Steps to Successful Breastfeeding?


To become Baby Friendly, hospitals must demonstrate that they comply with the following evidence-based policies:

  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 an 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 - that is, allow mothers and infants to remain together - 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no artificial teats or pacifiers to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic

What difference does it make if I birth at a Baby Friendly Hospital or somewhere else?

Research has repeatedly shown that mothers who birth at Baby Friendly hospitals are more likely to breastfeed, breastfeed longer, and breastfeed more exclusively. That’s because the 10 Steps to Successful Breastfeeding are based on research showing which policies support - and which undermine - breastfeeding.  So, while it’s certainly possible to breastfeed successfully if you don’t birth at a Baby Friendly Hospital, you will probably encounter far fewer barriers to meeting your breastfeeding goals if you birth at one.

How can I find a Baby Friendly Hospital near me?

As of December, 2011, there were 125 Baby Friendly Hospitals in the U.S.  You can find a complete list of them here.

Many hospitals are in the process of becoming Baby Friendly, and the Centers for Disease Control recently announced that they’ll be supporting the certification of many more.  Kaiser Permanente also recently announced an initiative to make many of their hospitals Baby Friendly.

What can I do if I don’t live near a Baby Friendly Hospital, or my insurance limits my options?

Sadly, many mothers don’t live near a Baby Friendly hospital.  The CDC estimates that only 5% of all births occurs at a Baby Friendly Hospital today.  And the unfortunate truth is that most hospitals don’t meet the Ten Steps to Successful Breastfeeding.  In 2009, for example, only one in three hospitals reported to the CDC that they practicing rooming in (Step 7).

This is changing, but if you’re pregnant now you can’t exactly wait!  So what can you do if you can’t birth at a Baby Friendly Hospital but want the best breastfeeding care you can get?

  1. You can write a breastfeeding-friendly birth plan, based on the Ten Steps to Successful Breastfeeding, and discuss with your providers your wishes for a birth and newborn period that supports your intention to breastfeed.  If you’re planning to birth at home, you can discuss these same issues with your providers.
  2. You can request your area hospitals’ mPINC scores.  One relatively unknown fact is that all hospitals report their compliance with the Ten Steps to Successful Breastfeeding to the CDC.  The CDC compiles this information and gives each hospital a score, known as the mPINC score.  Hospitals do not have to disclose their performance to the public, but mothers are free to request it from their local hospitals if they wish.  This information, if you can get it, could be useful in evaluating how breastfeeding-friendly your birth options are.
  3. And if you’re feeling ambitious, you can launch a community campaign, as these mothers did, to push your local hospitals to become Baby Friendly!