Is Your Hospital Anti-Baby?
Pregnant women – a public service announcement: the facility of choice for your birth experience might be Baby-Hostile. You should probably check.
The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) has created a “global initiative” entitled The Baby-Friendly Hospital Initiative (BFHI). And thank goodness. What new mother would want to be around people who hate babies? I’m sure they’re promoting things like baby blankets, diapers, stuffed toys. Maybe they have elderly people volunteering to be temporary grandparents. They probably have Twinkle Twinkle Little Star on heavy rotation in the nurseries, which of course are outfitted in top-to-bottom Pottery Barn Kids.
Here’s what the BFHI website says the organizations mission is: (https://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative)
The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding.
Oh. It’s a breastfeeding initiative. I see. Now, full disclosure – I did not breastfeed my kids. I tried it with the first one. For a week. It hurt. I dreaded feedings. The baby didn’t like it. She cried. I cried. We stopped trying. Our relationship got much better. So far, my kids are healthy, happy, normally-weighted, and intelligent.
So breastfeeding is Baby-Friendly. Which implies that if you are not breastfeeding, or promoting breastfeeding, you are, what, Baby-Unfriendly? Anti-Baby? Baby-Neutral? Well, regardless of what BFHI is implying, it is most definitely not Mother-Friendly. Here are those Ten Steps:
- Have a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff in the skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within one hour of birth.
- Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
- Give infants no food or drink other than breast-milk, unless medically indicated.
- Practice rooming in – allow mothers and infants to remain together 24 hours a day.
- Encourage breastfeeding on demand.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.
Those are awesome recommendations! For women who are really motivated to breastfeeding and don’t require sleep, with babies who also take to breastfeeding like proverbial fish. It will be a perfect nightmare for anyone else. Breastfeeding hurts at first. Babies do not always take to it right away. Milk comes in late, or in short supply. Mothers are human beings who need sleep. In a Baby-Friendly hospital, if you can’t or don’t want to breastfeed, if your child has trouble getting the hang of it, if you have other kids at home and really need a rest before you go home with this one, well, your hospital stay will be less than pleasant and probably not a great way to start the journey of motherhood.
Well, what does BFHI say about this?
When a mother specifically states that she has no plans to breastfeed or requests that her breastfeeding infant be given a breast milk substitute, the health care staff should first explore the reasons for this request, address the concerns raised, and educate her about the possible consequences to the health of her infant and the success of breastfeeding. If the mother still requests a breast milk substitute, her request should be granted and the process and the informed decision should be documented. Baby‐Friendly is not about making a mother feel guilty; it is about preventing her regret for decisions made without the proper information. Further, Baby‐Friendly policies protect the mother from the influences of commercial interests so that she may make decisions on the basis of scientific evidence and not marketing material.
We Baby-Friendly hospitals know that grown women can’t protect themselves from Similac and won’t take responsibility for their own decisions. I mean, we have “allowed” mothers and infants to remain together 24/7 after all. Mothers who make bad decisions…well, at least we made them sign something acknowledging their unfitness as mothers. Not to make them feel guilty or anything.
Along comes the Journal of the American Medical Association (JAMA), to save the day. In an article published in August, a meta-analysis found that such institutional implementation of breastfeeding policies don’t actually have the effect of increasing breastfeeding rates. http://jamanetwork.com/journals/jama/article-abstract/2571222#.WBjMUzJ8KfY
In contrast to evidence supporting individual-level interventions [which do work], the evidence review included nine fair- to good-quality studies evaluating the effectiveness of system-level primary care interventions to support breastfeeding and reported that there was no consistent association between system-level interventions and any beneficial outcomes.
Well, when the Baby Friendly folks got wind of this, they struck back with a two-page statement that started with accusing the JAMA article of being “filled with comments not supported by research”. They cited research to support their side (R. Pérez‐Escamilla, J. Martinez and S. Segura‐Pérez, “Impact of the Baby‐friendly Hospital Initiative on Breastfeeding and Child Health Outcomes: A Systematic Review. doi: /mcn.12294.,” Maternal Child Nutrition, 2016) and published an opinion paper in the October issue of JAMA laying out their evidence.
A recent meta-analysis of studies evaluating the BFHI found that the implementation of the BFHI increased exclusive breastfeeding by 49% and any breastfeeding by 66%. (http://jamanetwork.com/journals/jamapediatrics/article-abstract/2546143)
Well, sure, if you bully and guilt women into it. And who is right about such initiatives anyway? The people that think it helps, or the people that don’t? Who the F@#$!% cares? You know who is right? The mother is. Each individual woman, the adult, thinking being attached to the breasts and producer of the milk in question, decides what to do for herself and her baby. And she’s right.