People ask me all the time, why I gave birth to both my babies in Fullerton, CA when we live in Redlands, CA. This decision was probably one of the more simple ones I made during my process of pregnancy either time. My family struggled with it because of the distance, but for me- there was literally no question.
Why? Because I gave birth in a Baby Friendly hospital. My first was 3 weeks early, breech and very difficult, so he was a C-Section baby. My second, was a very successful VBAC baby, using the Hypnobabies birthing method. I had amazing birth experiences with both babies and would absolutely not change a single thing about either one. I believe this is the case because my hospital of choice was a Baby Friendly Initiative Hospital.
What is a “Baby Friendly” hospital? Don’t we just assume that any hospital is a baby friendly one? I mean, they pretty much all support pregnancy, birth, NICU care, they provide the mama with a comfortable place to birth and spend the first few days with their new baby and then send them off with a card signed by the attending nurses and sometimes even, a care package of wipes, diapers and random baby stuff you will need in the first days. So, how can we not say that any hospital is a “baby friendly” one?
Baby-Friendly USA is an organization that supports hospitals in the care of the pregnant, birthing and postpartum mom to ensure she is given every opportunity to be well informed on baby-wearing, skin-on-skin and breastfeeding in concordance with the Baby Friendly Hospital Initiative. This is something EVERY expectant mother aught to know when researching where to have their baby. If you are planning on a hospital birth rather than home or birth center, do yourself and your new baby the best favor you can and make sure your hospital supports and adheres to the BFHI standards.
What is the BFHI?
The Baby-Friendly Hospital Initiative (BFHI) is a global program that was launched by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) in 1991 to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. It recognizes and awards birthing facilities who successfully implement the Ten Steps to Successful Breastfeeding (i) and the International Code of Marketing of Breast-milk Substitutes (ii). The BFHI assists hospitals in giving all mothers the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies or feeding formula safely, and gives special recognition to hospitals that have done so.
Becoming a Baby-Friendly facility is a comprehensive, detailed and thorough journey toward excellence in providing evidence-based, maternity care with the goal of achieving optimal infant feeding outcomes and mother/baby bonding. It compels facilities to examine, challenge and modify longstanding policies and procedures. It requires training and skill building among all levels of staff. It entails implementing audit processes to assure quality in all aspects of maternity care operations. The journey is exciting, challenging, and worth it! It creates opportunities to develop high performance work teams and build leadership skills among staff, promotes employee pride, enhances patient satisfaction and improves health outcomes.
i.The Ten Steps to Successful Breastfeeding, Protecting, Promoting and Supporting Breast-feeding: The Special Role of Maternity Services. Geneva: WHO, 1989.
ii. International Code of Marketing of Breast-milk Substitutes. Geneva: WHO, 1981.
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This label is not just for fun- it’s hard work for a hospital to gain this status and means they must be willing to deviate from the rigid regulations that are more time/money/resource- focused than baby-focused. When I had my first child, I didn’t realize how amazing this was. I took for granted all the amazing opportunities I was given because of their hard work, never knowing not EVERYONE gets to have the experiences I did. Time and again, I heard about women’s horror stories of scary birth experiences and pushy after care. I began to understand that there had be a difference. When I had my second baby, it was absolutely no question where I was going to give birth- 71 miles was a small price to pay to ensure the level of care I knew I wanted.
One area specifically focused on in a Baby Friendly hospital, is breastfeeding. I became aware very quickly after we returned home, that my experience with the hospital staff at St. Jude was not normal. I left that hospital a confident, nursing mother. This was after we had a major dip in my baby’s weight that almost prevented him from getting to go home with us. It required supplementation with both formula and pumped milk. It is my belief that the Baby Friendly Hospital Initiative enforced by my hospital is THE REASON we left that hospital with no formula and strong skills in effective breastfeeding. I listened to other mothers share their experiences and how they were told to stop breastfeeding and switch to formula, or to pump and provide the baby pumped milk in a bottle to get their weight up, while supplementing with sugar water or formula. They seemed confused why I was the confused one- when I passed forward the wealth of knowledge I had been given in my four days under the St. Jude roof about nipple shields, nipple guards/shells, syringe feeding and block feeding. They took offense at how “easy” it seemed for me when they were told it just wasn’t possible for them and to do the right thing for their baby, they needed to leave behind any dreams of breastfeeding. They were told that the desire was selfish, for THEM, and not for baby. They were told it was more important for the baby to be given formula and get on with life, rather than worry about being able to breastfeed. They were told by doctors and nurses things like, “not every mother can do it”, or, “that’s what formula is for”, dismissing their desires to nurse and making them feel guilty for wanting to. Even something as natural as nursing through pregnancy seemed completely strange to some people, scary even- but my doctor encouraged it for the health and well being of our family as a whole.
I continued to hear stories like this and I still do- but now I understand why. Nurses and doctors (even post-natal pediatricians and attending birth nurses) don’t REALLY know all there is to know about breast milk, breast feeding or the intense value it has over and above any other method of infant nutrition and they just don’t have a strong level of commitment to help you with the process. Their job is to keep you and baby healthy, by any means necessary and usually by whatever means is easiest to accomplish.
Unless they have been trained and work within the BFHI system.
Knowing what I know now, still nursing both a three year old and an 18 month old and helping new mamas to gain confidence in their nursing journey in every way possible, I believe my success and the continued success of anyone I can help, is because of the work these people accomplish.
My passion for breastfeeding education and my desire to further my education through schooling at some point, can be traced back to the amazing consultant who came to help me learn how to breastfeed when I thought I already knew how. If it hadn’t been for her, I truly believe I wouldn’t be here today, doing what I do.
This is what it looks like in a BF hospital:
I was given daily care by a lactation consultant and in the first two days, she returned to my bedside THREE TIMES A DAY to make sure I was doing okay. On the third day, she called me on the phone and asked me if I felt I needed her to come in and see us. Once I left the hospital, I made an appointment with her at their “Mother/Baby Wellness Center” across the street. When the baby was a week old, I returned. They weighed him, weighed me, did a scar check on me, talked to me about my mood and overall health, did an exam on the baby and then watched me breastfeed, gave pointers in the hold I was using, how to hold his head, how to sit so my back didn’t get tired, they discussed fluid intake and diet changes to help make breastfeeding easier, they taught me about food aversion through milk and what to eat to make baby want more, as well as what I could eat and drink that would help increase my production. They taught me about the myth of “colic” and how to attempt methods of nursing such as block feeding and extended feeding, how to keep him from falling asleep at the breast and how to supplement with a syringe instead of a bottle to ensure he wouldn’t reject the breast out of laziness.
Another area BFUSA hospitals excel in, is respecting birth plans and creating an atmosphere of safety, comfort and a true focus on the connection between mother, father and baby at all times. A BFUSA hosptial will NEVER refuse a sibling the opportunity to be present during a birth. I was able to nurse my 22 month old WHILE IN HARD LABOR with my daughter and I kept him in bed with me through much of the day, nursing, until he was too tired and antsy then his auntie came to take him home to his own bed.
A BFUSA hosptial is open to birth plans and medication desires. They will suggest and do whatever it takes to make a VBAC happen if you want it, they encourage midwife/doula assistance, they are respectful of your wishes, and they will NEVER- NEVER- NEVER separate you from your baby. My son, who was a C-Section baby, was handed to me WHILE they were sewing me up. Not after. They encouraged me to do skin-to-skin that minute and reminded me while I was all loopy that I needed to help him latch for the first time.
If YOU did not have this experience in your hospital- it is likely they were not a Baby Friendly Hospital. Do your research and give you and your new baby the best gift possible- an amazing start in a facility that puts YOUR and BABY’S needs before their own. Ask your OB if the delivering hospital is a BFUSA certified location and if not- find one that is.
It is worth it.
The Cautious Mom 