Are You Baby Friendly?

Sandy Beauman, MSN, RNC-NIC


Obtaining Baby Friendly status has been a hot topic for several years now.  Perhaps your hospital is in the process of obtaining this designation or you have been Baby Friendly for some time.  According to the Baby Friendly Hospital Initiative, to date, there are more than 20,000 centers in 150 countries who have met the Baby Friendly criteria (

The website also indicates that there are 92 hospitals in the United States who have obtained this designation as of July 29, 2014, a small percentage of all hospitals providing maternity care (  The following 10 Steps to Successful Breastfeeding are part of the initiative originally designed by UNICEF and WHO (World Health Organization).

  1. Have a written breastfeeding policy that is routinely communicated to all health care staff.
  2. Train all health care staff in the 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 are separated from their infants.
  6. Give infants no food or drink other than breast-milk, unless medically indicated.
  7. Practice rooming in – allow mothers and infants to remain together 24 hours a day.
  8. Encourage breastfeeding on demand.
  9. Give no pacifiers or artificial nipples to breastfeeding infants.
  10. Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.

These individual steps don’t seem that difficult.  However, there is a difference between having a written policy and enacting that into the culture of the institution.  Every healthcare worker who comes in to contact with pregnant women and/or newborns must enact the intent of the policy.  Over the years, I have seen the tide turn one way and another regarding acceptance and support of breastfeeding.  As I have stated in previous blogs, there is no doubt now that research shows clear benefit to feeding of breast milk in the premature infant.  What may be uncomfortable for some is the communication of this knowledge to a mother who has already decided not to provide breast milk.  However, creating a culture where breastfeeding is the norm decreases the chances of mothers deciding that this is not the preferred feeding method and baby food.  Over the years, we have seen acceptance that smoking and drinking while pregnant or taking over the counter medications are not in the best interest of the baby.  What new mother doesn’t want what is best for her unborn baby?  The same public education could inform the general public and change the culture to increase breastfeeding rates.  Many women have made a decision about whether to breastfeed or not before becoming pregnant and virtually all have decided by the time they deliver a full term infant.   The time to have the most impact on this decision is before delivery, not after.  After delivery, the focus should be supporting that decision and providing support and assistance with any challenges the mother may encounter.

There are so many decisions made during pregnancy and raising a child when no one would accept “just good enough” rather than what is best, if it is within reach.  So, why accept feeding artificial baby formulas when breast milk is or can be available in most circumstances?

Looking for additional reading from Sandy Beauman’s professional perspective?
View her blog entry Obtaining Breast Milk: What Is The Future?


About the Author

Sandy Sundquist Beauman has over 30 years of experience in neonatal nursing. In addition to her clinical work, she is very active in the National Association of Neonatal Nurses, has authored or edited several journal articles and book chapters, and speaks nationally on a variety of neonatal topics. She currently works in a research capacity to improve healthcare for neonates. Sandy is also a clinical consultant with Medela. You can find more information about Sandy and her work and interests at