Breastfeeding Standards for King County Hospitals

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Policy Statement

King County Hospitals shall have breastfeeding policies and procedures in place based on scientific research. Breastfeeding is the gold standard for achieving optimal infant and child health, growth and development. The goal is to guarantee that care, which supports and protects breastfeeding, is consistently given regardless of which King County hospital the birth occurs. These standards reflect the current policy statement by the American Academy of Pediatrics and the UNICEF/ WHO Baby Friendly Hospital Initiative.

1. Human milk is the preferred feeding for all infants, including premature and sick newborns with rare exceptions. The ultimate feeding decision on feeding of the infant should be the mother's. Health care providers should provide parents with complete, current information of the benefits and methods of breastfeeding to ensure that the feeding decision is a fully informed one. When direct feeding is not possible expressed human milk, fortified when necessary for the premature infant, should be provided.



2. Breastfeeding should begin as soon as possible after birth, usually within the first hour. Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized.



3. Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing or rooting. Crying is a late indicator of hunger. Newborns should be nursed approximately 8-12 times every 24 hours until satiety, usually 10-15 minutes on each breast with a range of 5-30 minutes. In the early weeks after birth, non-demanding babies should be aroused to feed if 3-4 hours have elapsed since the last nursing. Continuous rooming in facilitates appropriate initiation of breastfeeding. Formal evaluation of breastfeeding effectiveness should be done by trained observers and fully documented in the record during the first 24-48 hours and again at an early follow up visit which should occur 48-72 hours after discharge. Further feeding problems should be referred to a health care provider with expertise in lactation management.



4. No supplements (water, glucose water, formula etc.) should be given to newborns unless a medical indication exists (See supplementation policy). With sound breastfeeding knowledge and practices, supplements are rarely needed. Pacifiers should be avoided in the hospital unless a baby and mother are separated by illness.



5. When discharged less than 48 hours after delivery, all breastfeeding mothers and their newborns should be seen by a pediatrician or other knowledgeable health care provider when the newborn is 2-4 days of age. In addition to a breastfeeding observation, the infant should be assessed for adequate hydration, jaundice and age appropriate elimination patterns. All newborns should be seen again prior to one month of age.



6. Parents will be instructed that exclusive breastfeeding is the ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months of life. Gradual introduction of solids begins in the second half of the first year. It is recommended that breastfeeding continue for at least 12 months and thereafter as long as mutually desired. Increasing the rates of breastfeeding initiation and duration is a national health objective and one of the goals of Healthy People 2000.



7. Parents will be instructed that in the first 6 months water, juice and other foods are generally unnecessary for breastfed infants. Vitamin D and iron may be given before 6 months of age in selected groups of infants. Fluoride should not be administered to infants in the first 6 months after birth. During the period of 6 months to 3 years of age breastfed infants require fluoride only if the water supply is severely deficient in fluoride.

Should hospitalization of the breastfeeding mother or infant be necessary, every effort should be made to maintain breastfeeding, preferably directly, or by pumping the breasts and feeding expressed breast milk, if indicated.

Supplementation Policy

Breastfeeding Policy

Vendor Policy

Fresh Donor Breastmilk Policy & Guidelines

Breastfeeding Standards for King County Hospital