If you happened to be visiting Florence, Italy in August 1990, you may have been near the conception of the Baby-Friendly Hospital Initiative (BFHI). The United States Agency for International Development and the Swedish International Development Authority sponsored a World Heath Organization (WHO) and United Nations Children’s Fund (UNICEF) policymakers meeting at the Spedale degli Innocenti. The result was the Innocenti Declaration: On the Protection, Promotion and Support of Breastfeeding. This Declaration gave a voice to the littlest voiceless ones around the world—our babies.
Recognizing the decline of breastfeeding worldwide and the health consequences of this decline, leaders moved forward with aggressive plans to ensure human babies would have human milk. In 1991, the BFHI was officially launched by executive leadership from WHO and UNICEF with the goal to transform health care policies in order to restore breastfeeding as the norm.
In the United States we take for granted that we have clean water to mix with powdered infant formula, a plentiful supply of uncontaminated formula and access to supportive agencies if we cannot afford formula. If you ask most people, they would say that formula-fed babies are just fine and do not suffer any health effects from not receiving breast milk. In other words, the consequences of drifting from a breastfeeding culture to a formula-feeding culture may have gone unnoticed by most Americans.
However, a more global perspective paints a very different picture. By the 1960’s, formula companies’ marketing in developing countries was recognized as a leading cause of preventable death among infants. According to UNICEF, “If every baby were exclusively breastfed for six months, an estimated 1.3 million additional lives would be saved every year, and millions more would benefit in terms of health, intelligence and productivity. Breastmilk is the perfect food—it contains all the nutrients and micronutrients an infant needs for normal growth during the first six months of life.” Without access to clean water, infants who are formula fed starve or die of diseases caused by contaminated water. The health benefits of breast milk and the consequences of formula feeding in second- and third-world countries are so dichotomous that even HIV-positive women in these countries are encouraged to breastfeed.
Now let’s come back to the United States. Does breastfeeding make any difference or is the decision to breastfeed or formula feed as inconsequential as choosing between Coke or Pepsi? According the Surgeon General, breastfed babies and their mothers are healthier. In her January 2011 Call to Action to Support Breastfeeding, our Surgeon General points out that babies who are breastfed are less likely to suffer from gastroenteritis, ear infections and pneumonia. They are less likely to die of Sudden Infant Death Syndrome (SIDS). Babies are less likely to develop asthma, and their mothers are less likely to have breast or ovarian cancers. It is estimated that if 90 percent of mothers in the U.S. breastfed exclusively for six months, we would annually save $13 billion in reduced medical and others costs. Talk about health care reform! We could go a long way with just improving breastfeeding success.
In summer 2011, the Center for Disease Control (CDC) published in their Vital Signs a report that breastfeeding can prevent obesity but that hospitals are not doing everything they can do to help women breastfeed. The CDC’s solution? Hospitals should work toward Baby-Friendly designation. The Joint Commission, which is the accrediting agency for hospitals, added “exclusive breastfeeding” to their Perinatal Core Measure Set in April 2011. Their guidelines on how to achieve increased exclusive breastfeeding includes recommendation to seek Baby-Friendly designation.
Around the world there are more than 15,000 Baby-Friendly hospitals in 134 countries. In September 2010, Goshen Hospital became the 100th Baby-Friendly hospital in the U.S. It took 20 years for 100 U.S. hospitals to understand there is value in promoting breastfeeding through exceptional maternity care policies and practices. In the last year, 21 more hospitals have earned designation, and 268 are in the process. A Healthy People 2020 goal is to increase the percentage of Baby-Friendly hospitals from 4% to 8%. The goal will likely be met and possibly exceeded. I’m proud my hospital part of the movement!