Step 6: Human Milk for Human Babies

In 2011 nearly 80 percent of women who delivered at Memorial Hospital started out wanting to breastfeed. A few of those, 9 percent, gave up breastfeeding during their hospital stay. Many, 48 percent, supplemented feedings with formula at least once.*

Reasons for supplementing vary; some are medical, but many are personal. Plans for more careful data collection, following Joint Commission guidelines, are underway. For now, one thing we do know for sure is that changes associated with Baby-Friendly designation help decrease the number of babies who receive formula during their hospital stay.  Mothers who exclusively breastfeed in the hospital are more likely to continue breastfeeding their babies in the weeks and months to come (Cox, 2010).

For some statistical inspiration, consider the success of Boston Medical Center, an urban hospital serving primarily low-income, minority patients. They were one of the first Baby-Friendly hospitals in the U.S. In 1995 their breastfeeding initiation rate (babies receiving any breast milk at all) was 58 percent but rose to 86.5 percent by 1999 when they earned Baby-Friendly designation. In the same period of time, exclusive breastfeeding rates for African-American mothers rose from 34 to 74 percent.

Again and again, research demonstrates that the 10 Steps to Successful Breastfeeding created by UNICEF and required to become Baby-Friendly, help families experience breastfeeding success.

Here is our Self-Assessment for step 6.

Step 6. Give newborn infants no food or drink other than breast milk, unless medically indicated.

6.1  Do breastfed babies receive no food or drink (other than breast milk) unless medically indicated?  No

6.2  Does staff have a clear understanding of what the few acceptable reasons are for prescribing food or drink other than breast milk for breastfeeding babies? No

6.3  Does staff explore reasons with mothers who have decided not to breastfeed, discuss the risks of not breastfeeding, various feeding options and help them decide what is suitable in their situation? No

6.4  Does staff explore reasons and provide education to breastfeeding mothers who request breast milk substitute supplementation on the risks of such supplementation and help them decide what is suitable in their situation? No

6.5  Is the education and informed consent for breast milk substitute supplementation documented in the patient record? No

6.6  Are there written orders for evidence-based medical indications for breast milk substitute supplementation? No

6.7  Does the facility have adequate space away from breastfeeding mothers and the necessary equipment and supplies for teaching mothers who are formula feeding their babies how to properly prepare formula? No

6.8  Are all clinical protocols related to infant feeding current and evidence-based? No

Many “No” answers, but not for long!

*Formula supplementation data was not tracked until the 4th quarter of 2011. The breastfeeding initiation rate reflects all of 2011, but the supplementation data is only for the 4th quarter.

Cox, S. (2010). Clinics in human lactation: Altering hospital maternity culture. Amarillo, TX. Hale Publishing.

The Baby-Friendly Hospital Initiative at Boston Medical Center


About blogtobabyfriendly

blogtobabyfriendly is written by Amy Murray, a Childbirth Unit nurse with a touch of earth muffin crunch. A childbirth educator and IBCLC, she's been a breastfeeding advocate all her adult life, believing that if our bodies make milk, it just makes good sense to feed it to our babies. blogtobabyfriendly is her hospital's journey to Baby-Friendly designation. Click to get email updates on new blog posts. Our desire is to learn, share, and learn more.
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One Response to Step 6: Human Milk for Human Babies

  1. Olivia says:

    I’d love not only for there to be a written policy of what constitutes a medical necessity for giving formula, but to have that available to give to mothers before they give birth.* Three years ago I was told that since my baby had not urinated since birth (but who knows if she did at the time of the c-section or if any urine had come out during her first dirty diapers) she needed to be given and ounce of formula or an ultrasound to check her kidneys. I was not happy about that, especially since breastfeeding was going well.

    *It would also be nice to have a written policy of what procedures are standard during labor and delivery that is available to patients. I asked my midwife for one and she said it doesn’t exist.

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