Breastfeeding promotion

Nature designed human milk for human babies; it provides infants with the best source of nourishment for healthy growth and development. Yet some aspects of health care, industry and society in general have evolved in ways that are not conducive to breastfeeding support and success.

Breastfeeding is associated with decreased risk for infant morbidity and mortality as well as maternal morbidity. The benefits do not end when breastfeeding does, but can extend into and after toddlerhood.

Exclusive breastfeeding is recommended for the first six months of life. Continue breastfeeding for a year or as long as mother and baby desire.

The decision to breastfeed is an important one. New mothers and new parents should feel comfortable seeking help and finding sources of peer and professional support. The free Arkansas Breastfeeding Help Line is available 24 hours a day, seven days a week. The phone number is 800-445-6175. Call to speak to a registered nurse lactation consultant. The lactation consultant can help new moms, pregnant women and health care providers with information about common breastfeeding concerns. The Arkansas Breastfeeding Help Line is sponsored by the Arkansas Department of Health and Baptist Health.

Increasing breastfeeding rates is a national priority, and improvement is needed to protect, promote and support breastfeeding. AFMC is working with the Arkansas Department of Human Services to promote best practices for increasing breastfeeding success as part of our larger effort to improve maternal and child health statewide.

Breastfeeding promotion: physicians’ office strategies for success

Improve office systems create a breastfeeding-friendly office

  • Establish a written breastfeeding-friendly office policy
  • Collaborate with colleagues and office staff during development
  • Provide staff education and training
  • Provide copies of your practice’s policy to hospitals and covering physicians
  • Develop and follow telephone triage protocols to address breastfeeding concerns and problems
  • Integrate breastfeeding promotion, education and support throughout prenatal care
  • Take a detailed breastfeeding history as part of the prenatal history
  • Consider the culture of women, families and communities
  • Incorporate breastfeeding as an important component of the initial prenatal breast exam
  • Discuss breastfeeding at each prenatal visit
  • Enable women and their families to have the birth experience most conducive to breastfeeding

Provide an office environment that demonstrates breastfeeding promotion and support

  • Provide a lactation room for employees who breastfeed or express breast milk at work
  • Eliminate the distribution of free formula and baby items from formula companies to parents
  • Store formula supplies out of view of parents
  • Display posters, pamphlets, pictures and photographs of breastfeeding mothers
  • Do not display images of infants bottle-feeding
  • Target display image material to populations with low breastfeeding rates
  • Do not accept gifts or samples from companies manufacturing infant formula, feeding bottles or pacifiers
  • Employ a lactation consultant or nurse trained in lactation

Improve patient experience

  • Do not interrupt or discourage breastfeeding in the office
  • Allow and encourage breastfeeding in the waiting room
  • Display signs in waiting area encouraging mothers to breastfeed
  • Provide a comfortable private area to breastfeeding mothers who prefer privacy
  • Conduct follow-up phone calls to assist breastfeeding mothers
  • Encourage breastfeeding mothers to feed newborns only breast milk
  • Avoid offering supplemental formula or glucose water unless medically indicated
  • Commend breastfeeding mothers during each visit for choosing and continuing breastfeeding
  • Provide breastfeeding anticipatory guidance in routine periodic health maintenance visits
  • Encourage fathers of infants to accompany mother and baby to office visits
  • Encourage mothers to exclusively breastfeed for six months and continue breastfeeding for a year, or as long as mother and baby desire
  • Continue to support breastfeeding as long as it is the right choice for mother and baby

Education

  • Provide access to a multilingual staff, translators and ethnically diverse educational material
  • Instruct mother to not offer bottles or a pacifier until breastfeeding is well established
  • Breastfed babies should receive 400 IU of vitamin D each day starting in the first few days of life and continuing until babies are weaned to at least one liter or one quart of vitamin D-fortified formula or milk a day (American Academy of Pediatrics)
  • Early in the pregnancy, it is important to promote the Women, Infants and Children (WIC) program’s many benefits: healthy foods for pregnant women, nutrition education and referrals to other services
  • Breastfeeding questions answered 24/7 by the Arkansas Breastfeeding Helpline 501-202-7378 or 844-344-8408 (sponsored by Baptist Health Expressly for You and the Arkansas Department of Health)

Breastfeeding promotion: inpatient strategies for success

Labor and delivery care

  • Babies should be placed skin-to-skin with their mothers immediately after birth for at least one hour
  • Educate mothers to recognize when baby is ready to breastfeed and offer assistance as needed
  • Routine procedures are performed skin-to-skin

Feeding of breastfed infants

  • Initial feeding is breast milk (vaginal and cesarean births)
  • Give infants no food or drink other than breast milk unless medically indicated

Breastfeeding assistance

  • Infant feeding decision is documented in the patient chart
  • Staff provide breastfeeding advice, instructions and assistance
  • Provide instruction on how to maintain lactation even when separated from infant
  • Staff teach and encourage to feed on demand
  • Staff directly observe and assess breastfeeding
  • Staff use a standard feeding assessment tool
  • Staff does not provide pacifiers or artificial nipples to breastfeeding infants

Contact between mother and infant

  • Mother-infant pairs are not separated for postpartum transition
  • Mother-infant pairs room-in at night
  • Mother-infant pairs are not separated during the hospital stay
  • Infant procedures, assessment and care are in the patient room

Facility discharge care

  • Staff provide appropriate discharge planning (referrals and other multi-modal support)
  • Discharge packs containing infant formula samples and marketing products are not given to breastfeeding patients

Staff training

  • New staff receive appropriate breastfeeding education
  • Current staff receive appropriate breastfeeding education
  • Staff received breastfeeding education in the past year
  • Assessment of staff competency in breastfeeding management and support is at least annual

Structural and organizational aspects of care delivery

  • Breastfeeding policy is effectively communicated
  • Facility documents infant feeding rates in patient population
  • Facility provides breastfeeding support to employees
  • Facility does not receive infant formula free of charge
  • Breastfeeding is included in prenatal patient education
  • Facility has a designated staff member responsible for coordination of lactation care

Web resources

Breastfeeding policy

Academy of Breastfeeding Medicine (ABM)

Baby-Friendly USA

The 10 Steps to Successful Breaktfeeding

Breastfeeding FAQs

Centers for Disease Control and Prevention (CDC), Breastfeeding Report Card, United States, 2010

Breastfeeding Medicine Volume 4, Number 1, 2009 Clinical Protocol Number #19: Breastfeeding Promotion in the Prenatal Setting

U.S. Department of Health and Human Services, Initials. (2011). The surgeon general’s call to action.

Breastfeeding programs

The Texas Ten Step Breastfeeding Program

Ten Steps to Successful Breastfeeding

Breastfeeding laws

National Conference of State Legislatures (NCSL) State Breastfeeding Laws

Breastfeeding training for health professionals

Healthy Children’s Center for Breastfeeding, comprehensive breastfeeding management training

Health e-learning online education

Breastfeeding supportive services

Arkansas Breastfeeding Helpline – Breastfeeding Questions Answered 24/7
800-445-6175

Arkansas Department of Health Peer Counselor Program

Arkansas WIC Program

Kellymom provides evidence-based information on breastfeeding, sleep and parenting

La Leche League (LLL) mothering through breastfeeding

The United States Breastfeeding Committee (USBC) works to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding

The American Academy of Pediatrics (AAP) provides detail information for parents, healthcare professionals and advocates

The Arkansas Breastfeeding Coalition is dedicated to protecting and promoting breastfeeding in Arkansas

Breastfeeding support

Breastfeeding checklist for nursing mothers