'If you are a baby-friendly hospital, breastfeeding should be the norm'

Who would have thought that you’d need to set up a baby-friendly hospital initiative in maternity hospitals across the world?

Well, that’s exactly what the World Health Organisation and Unicef did in 1991 because they felt that the campaign to increase breastfeeding rates wasn’t going anywhere if hospitals weren’t supportive of breastfeeding.

“The initiative came to Ireland in 1998 and most maternity hospitals/units in Ireland are at various stages in the process to reach the baby-friendly award,” says Genevieve Becker, the national co-ordinator of the baby-friendly hospitals initiative (BFHI) in Ireland.

About 40 per cent of babies born here are born in a maternity hospital/unit which has reached the criteria required by the BFHI.

Eight maternity hospitals/units are currently designated as WHO/Unicef baby-friendly hospitals (see panel).

To be designated as a baby-friendly hospital, the maternity hospital/unit must comply with the "10 steps to successful breastfeeding" (see breastfeeding.ie).

These include helping mothers initiate breastfeeding within 30 minutes of birth and not giving babies any food or drink other than breast milk unless medically indicated.

The hospitals must also comply with the international code of marketing of baby formula which prevents the marketing and distribution of baby formula within the hospital.

“Once gained, the hospital is designated a baby-friendly hospital for five years but they are monitored every year and have a full assessment after five years,” explains Becker, who is also a certified lactation consultant. Pregnant women, new mothers and staff at the hospital are interviewed as part of the assessment.

Speedy delivery

“It’s more difficult for large hospitals to achieve the baby-friendly hospital award because they have more sick mothers and a higher turnover of staff but it can be done,” she says.

According to Becker, the difficulty with larger hospitals is that they are busy and understaffed, they can tend to focus their activity on the clinical elements of speedy delivery and high bed turnover with not enough time allocated to helping mothers become confident mothers.

“If you are a baby-friendly hospital, breastfeeding should be the norm. Mothers shouldn’t need to choose or opt into breastfeeding but they are free to opt out of it,” she adds.

Mothers who choose to formula feed are also given all the information they need on how to feed their babies.

“Baby-friendly hospitals don’t have nurseries where babies go at night time. All healthy babies are given to their mothers immediately at birth and stay with their mothers until discharge. And skin-to-skin contact occurs as the normal practice for all mothers and babies,” says Becker, who advises parents or staff of baby-friendly hospital to ask questions if such practices are not followed.

Changes in practices

Siobhán Hourigan, the national breastfeeding co-ordinator with the HSE, says, “hospitals across the world that have attained the baby-friendly hospital designation have had a directly associated improvement in breastfeeding rates and practices”.

Irish breastfeeding rates have been gradually increasing in recent years.

“Changes in practices in maternity services through involvement in the baby-friendly hospital initiative have contributed to the increase in rates.”

Ultimately, it’s the babies who count most, according to Becker.

“This is the baby-friendly initiative not the mother-friendly initiative – the baby is our focus as the most vulnerable person in the situation and the person who cannot speak for him/herself.

“The good start they receive in a baby-friendly hospital provides our communities with loving parents, skilled workers and innovators . . .

“Above all, babies who are cared for, learn to care for others, thus improving our world.”

Hospitals with WHO/Unicef Baby Friendly Hospital award

Portiuncula Hospital, Ballinasloe, Co Galway

Cavan General Hospital, Cavan

St Munchin’s Regional Maternity Hospital, Limerick city

The Rotunda Hospital, Dublin

The Maternity Unit at University College Hospital, Galway city

Our Lady of Lourdes Hospital, Drogheda, Co Louth

Midlands Regional Hospital at Mullingar, Co Westmeath

Midlands Regional Hospital, Portlaoise, Co Laois

See ihph.ie/babyfriendlyinitiative