What Makes a Breastfeeding-Friendly Hospital? A Closer Look
Breastfeeding is the normal way to feed an infant. It has the natural and immunological power to protect the health and improve well-being of both newborn babies and mothers. Yet, as the national data reveals, many hospitals struggle to provide the optimal environment to support breastfeeding mothers. Despite almost 90% gave birth in a hospital, less than half of them begin breastfeeding within an hour of birth and achieve critical skin to skin contact. (NFHS 5)
So, what exactly makes a hospital “breastfeeding-friendly”?
Breastfeeding-friendly hospitals are healthcare facilities that prioritise protection, promotion and support of breastfeeding to a certain standard. These hospitals take specific steps to provide services that create a supportive health system facilitating breastfeeding success.
Let’s take a closer look at the policies and practices that define such hospitals and what services these hospitals can provide to shape a better world for mothers and newborns.
- Adoption of UNICEF-WHO’s Ten Steps to Successful Breastfeeding
At the heart of a breastfeeding-friendly hospital is the implementation of the UNICEF-World Health Organization’s (WHO) Ten Steps to Successful Breastfeeding, which is an evidence-based structured framework to achieve desired goals.
These steps include:
- Having a clear breastfeeding policy communicated to all staff and a governance system to monitor and review the hospital data
- Preparing mothers for breastfeeding during pregnancy
- Training healthcare workers in breastfeeding support.
- Assisting with early initiation of breastfeeding within one hour of birth and skin-to-skin contact
- Ensuring rooming-in and breastfeeding on demand.
- Avoiding the use of artificial teats and pacifiers
- Avoidance of unnecessary use of commercial infant milks. formula
Tools to enable these steps are available and can be incorporated in daily hospital routines. Hospitals that implement all the Ten Steps, also become eligible to apply for being accredited “Baby-Friendly Hospitals” a programme Breastfeeding Promotion Network of India(BPNI) has been working on for more than 2 years.
Meanwhile BPNI is now providing many of these tools for FREE for all the maternity hospitals in India to begin step by step and make structural changes which will slowly give rise to improved breastfeeding rates. For example , one of these tools is to assist in data collection. If a hospital is interested in embarking on the journey of change, it is probably the best first step to take. Recording and periodically reviewing the rate of beginning of breastfeeding in an hour of birth, type of delivery , use of commercial infant milk, and skin-to-skin contact makes it easier for the hospital to be breastfeeding friendly.
Progress is possible. Allow me to share couple of evidence here,
In Cuba, Following the implementation of Baby friendly hospitals, the rate of exclusive breastfeeding in Cuba significantly increased, nearly tripling from 25% to 72% within a few years.
In one the studies BPNI found that just one step of preparing by education of pregnant women by trained counsellors led to increase in early breastfeeding from 33% to 73%.
Countries with early breastfeeding rates (within one hour of birth) above 80% are often those that have strong policies supporting breastfeeding. Here are a few such countries: Sri Lanka – Consistently reports early breastfeeding initiation rates above 90% due to strong hospital policies and breastfeeding promotion efforts. Bangladesh has an early breastfeeding rate of 65%, Rwanda has 89%, Bhutan -84%, Cambodia-82%, Malawi 76%, Ethiopia -73%, Peru-73%, Nepal 72% and Myanmar 66%. These countries demonstrate how coordinated policies and cultural practices can drive high breastfeeding rates.
- Early Skin-to-Skin Contact and Immediate Breastfeeding Support
Research has shown that placing newborns on their mother’s chest immediately after birth, with no separation for the first hour, increases breastfeeding success and strengthens the mother-baby bond. Even for mothers who have had caesarean sections, skin-to-skin contact can be facilitated in recovery rooms, with assistance and support from nursing staff.
- Exclusive Breastfeeding: No Formula Unless Medically Indicated
Breastfeeding-friendly hospitals strictly adhere to the practice of exclusive breastfeeding for newborns unless there is a medical reason to provide formula. Offering formula when it is not necessary can interfere with breastfeeding by disrupting the mother’s milk supply and creating confusion for the baby.
To support exclusive breastfeeding, hospitals should avoid any promotional materials from formula companies and educate mothers on the importance of breastfeeding. Formula should only be provided with informed consent and after the mother has been counselled on breastfeeding alternatives.
- Rooming-In: Keeping Mothers and Babies Together
A defining practice of breastfeeding-friendly hospitals is rooming-in, where mothers and their babies stay together 24 hours a day. This practice ensures that mothers can respond to their baby’s hunger cues and breastfeed on demand, which helps establish a healthy milk supply.
- Educating and Supporting Mothers Throughout Their Stay
Education is a crucial element in creating a breastfeeding-friendly environment. Maternity hospitals must ensure that mothers receive accurate information on breastfeeding and are provided with practical support throughout their hospital stay. This includes guidance on proper breastfeeding techniques, managing common breastfeeding issues (like latching problems), and hand-expressing milk.
Breastfeeding-friendly hospitals often employ lactation counsellors or specially trained nurses who work with mothers one-on-one.
- Ongoing Support After Discharge
Breastfeeding-friendly hospitals don’t just focus on the hospital stay—they also provide mothers with the resources and referral to continue breastfeeding successfully after they leave the hospital. This may be connecting with community-based breastfeeding support groups or follow-up consultations with lactation counsellor
Breastfeeding-friendly hospitals are a win-win for everyone involved: healthier babies, empowered mothers, and a future where breastfeeding is the norm, not the exception.
Join the movement Lets Turn Our Hospitals to be Breastfeeding Friendly
#BreastfeedingFriendlyHospitals
Dr. Arun Gupta
Central Coordinator BPNI