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Policy Statement
Extensive research, especially in recent years,
documents diverse and compelling advantages to infants, mothers,
families and society from breastfeeding and the use of human milk
for infant feeding. These include health, nutritional, immunologic,
developmental, psychological, social, economic and environmental
benefits. Increasing the rates of breastfeeding initiations and
duration is a national health objective and one of the goals of
Healthy People 2000.
Policy Guidelines
- Follow the AAP guidelines and the UNICEF/WHO
10 steps. This policy will be communicated to all staff caring
for mothers and babies.
- Encourage and support no separation of mothers
and babies. Babies who require special intensive care should still
have as much access to parents as possible.
- Assure that breastfeeding begins as soon as
possible after birth, usually within the first hour. Skin to skin
contact between mother and baby is to be encouraged.
- Teach parents that 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).
- Evaluate breastfeeding effectiveness by trained
observers and fully document in the medical record during the
first 24-48 hours and again at an early follow up visit, which
should occur 48-72 hours after discharge.
- Give no supplements to newborns unless a medical
indication exits. Each hospital should have a written supplementation
policy.
- Avoid pacifiers in the hospital unless a baby
and mother are separated by illness. Hospitals should not routinely
provide pacifiers except when baby is separated from mother due
to illness.
- Arrange a follow up appointment for 2-4 days
following hospital discharge. Babies need to be assessed for adequate
hydration, jaundice and age appropriate elimination patterns as
well as effectiveness of feeding at this visit.
- Maintain breastfeeding should hospitalization
of a breastfeeding mother or infant be necessary. Every effort
should be made to maintain breastfeeding, preferably directly,
or by pumping the breasts and feeding expressed breastmilk, if
indicated.
- Encourage mothers to nurse exclusively for
6 months and to introduce solids the second half of the first
year. Nursing should continue for at least 12 months and beyond
that as long as it is mutually desirable.
- Staff will participate in breastfeeding training
so that they are knowledgeable and skilled in both the physiology
and management of breastfeeding. Staff should promote and support
breastfeeding enthusiastically. Existing staff should obtain 18
hours of continuing education relative to lactation. New employees
should obtain this training within one year of employment.
- Have an IBCLC on staff available for consultation.
- Encourage physicians to write routine orders
that reflect the breastfeeding standards.
- Prohibit the distribution of infant formula
discharge packs, promotional items, educational materials or acceptance
of money from formula companies for education or supplies. A vendor
policy should be established that demonstrates an ethical business
relationship with infant formula vendors.
- Provide information to mothers about breastfeeding
support in each community.
- Create a work group to make sure that standards
are being followed and to assist the staff with compliance issues
as needed.
References
American Academy of Pediatrics Work Group on
Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics.
1997; 100 (6): 1035-1039.
Powers N., Slusser W. Breastfeeding Update 2:
Clinical Lactation Management. Pediatrics in Review. 1997; 18 (5):
147-161.
Lazarov M., Feldman A. WHO/UNICEF Ten Steps to
Successful Breastfeeding, United States Committee for UNICEF Annotated
Bibliography for each step, 1995.
Supplementation
Policy
Breastfeeding
Policy
Vendor Policy
Fresh Donor
Breastmilk Policy & Guidelines
Breastfeeding
Standards for King County Hospital |
Policy