Step 5: The Journey to the Baby-Friendly Designation

/ Community Design, Advocacy, Global Criteria, Healthcare / By

Step 5: The Journey to the Baby-Friendly Designation

As community advocates, the journey towards achieving the Baby-Friendly Hospital Initiative (BFHI) designation is often a challenging path, laden with obstacles and resistance, especially within large healthcare organizations. For years, Breastfeed Durham has navigated this demanding terrain, confronting a persistent ‘no’ from our region’s healthcare giant. The resistance to embracing breastfeeding-friendly practices within the Duke University Health System has been our most formidable challenge, symbolizing a broader struggle against entrenched healthcare norms.

Yet, our story is not just one of hurdles, but also of progress. After five years of unwavering advocacy, dedication, and strategic perseverance, the Durham community has achieved a significant victory: convincing Duke Regional Hospital to complete the BFHI designation. This success is more than just a milestone; it’s a beacon of hope and a testament to the power of community advocacy, relentless effort, and the possibility of change in even the most rigid systems.

In this article, we reflect on the strategies that propelled us forward. The path was filled with setbacks that tested our resolve, combatted by a collaborative spirit that fueled our mission. Our journey is one of incremental success, a reminder that every step forward, no matter how small, is a stride towards a larger goal. As we celebrate this achievement, we also acknowledge the mountains yet to climb in persuading the entire Duke University Hospital (fondly known as “Big Duke”) to pursue the BFHI designation.

Join us as we share our insights, lessons, and the unwavering spirit of advocacy that drives us to transform our healthcare landscape into a more breastfeeding-friendly community. Our journey is far from over, but each victory brings us closer to a world where breastfeeding support is not just an aspiration but a reality for every family.

Convincing Systems and Leadership

Convincing a hospital to pursue the Baby-Friendly Hospital Initiative (BFHI) designation, especially when there’s initial resistance, can indeed be challenging. A gradual multifaceted strategy can be effective in such situations. Here are some additional suggestions and expansions on your approach:

  • Engage and Re-engage Key Stakeholders: Continue engaging leadership, but also involve other stakeholders like midwives, lactation consultants, pediatricians, and obstetricians. Their support can be influential in convincing hospital administration.
  • Educational Initiatives: Offer educational sessions for hospital staff, including nurses, doctors, and administrators, about the benefits of breastfeeding/chestfeeding and BFHI. Use evidence-based research to highlight the positive outcomes for families, as well as the potential for reducing healthcare disparities.
  • Patient Advocacy and Community Engagement: Amplify your efforts to normalize breastfeeding and lactation in the community. Encourage patient advocacy groups to speak out. Organize community events, workshops, and support groups that promote breastfeeding and the importance of baby-friendly practices.
  • Incremental Implementation: Durham’s strategy is to work with health care systems to implement one requirement at a time. Celebrate each success and use it as leverage for the next step. Document and share the positive outcomes of each implemented step with the hospital leadership.
  • Addressing Concerns About Formula: Continue to work on changing the culture around formula giveaways. Highlight the WHO Code on the Marketing of Breastmilk Substitutes, and discuss how free formula can undermine breastfeeding efforts. Share research on how breastfeeding support can lead to better health outcomes, potentially reducing the need for formula.
  • Policy Advocacy: Work with local and national organizations to advocate for policies that support breastfeeding and the BFHI. This can include lobbying for insurance coverage for lactation support, maternity leave policies, and breastfeeding-friendly workplace laws.
  • Public Recognition and Marketing: Highlight the positive public image and marketing benefits of becoming a Baby-Friendly Hospital. Emphasize how this designation can attract more families seeking a supportive birthing environment.

Things to Say to the Hospital

The Baby-Friendly Hospital Initiative (BFHI) is a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) to encourage and recognize hospitals and birthing centers that offer an optimal level of care for infant feeding and mother/baby bonding. Pursuing the Baby-Friendly Hospital designation can bring several benefits:

  • Improving Maternal and Infant Health Outcomes: This program emphasizes breastfeeding, which is known to provide numerous health benefits to both infants and mothers. Breastfeeding is associated with a lower risk of certain infections, obesity, and diseases for babies, and a reduced risk of breast and ovarian cancer, and possibly osteoporosis and cardiovascular disease for mothers.
  • Enhanced Patient Satisfaction: Hospitals that adopt the Baby-Friendly standards often see an increase in patient satisfaction. Mothers who receive support and education about breastfeeding and bonding with their infants often have a more positive birthing and postnatal experience.
  • Promoting Best Practices in Maternity Care: The BFHI promotes evidence-based practices in maternity care, including skin-to-skin contact immediately after birth and rooming-in, where babies stay in the same room as their mothers. These practices can lead to better outcomes and a stronger mother-baby bond.
  • Public Health Impact: By promoting breastfeeding, hospitals can contribute to better public health outcomes in the community. Breastfeeding has been shown to reduce the incidence of common childhood illnesses and may contribute to lower healthcare costs.
  • Reputation and Recognition: Achieving the Baby-Friendly designation can enhance a hospital’s reputation in the community and among healthcare professionals. It demonstrates a commitment to high-quality maternity care and can be a point of pride and a marketing tool.

Pursuing the Baby-Friendly Hospital designation can significantly enhance the quality of care for mothers and infants, improve health outcomes, enhance patient satisfaction, and elevate a hospital’s standing in the healthcare community. Remember, change often takes time, especially in large organizations like hospitals. Persistence, along with a strategic and evidence-based approach, can gradually shift perspectives and practices towards a more breastfeeding-friendly environment.

Addressing Health Disparities

Research has shown that the Baby-Friendly Hospital Initiative (BFHI) can reduce racial and ethnic disparities in breastfeeding rates and maternal-infant health care. Several key points from various studies highlight the following:

  • Increased Breastfeeding Rates Across All Groups: BFHI helps increase breastfeeding initiation and duration rates among all racial and ethnic groups. This is particularly important because historically, there have been significant disparities in breastfeeding rates, with Black and Hispanic mothers having lower rates compared to White mothers. By providing equal support and education to all mothers, BFHI helps bridge this gap.
  • Promotion of Equitable Care Practices: The initiative promotes practices that support breastfeeding, such as skin-to-skin contact and rooming-in, which are beneficial for all mothers and infants, regardless of race or ethnicity. This standardized approach to maternal-infant care can help reduce disparities in care practices and outcomes.
  • Education and Support for All Mothers: BFHI hospitals provide breastfeeding education and support to all mothers, which can be especially beneficial for groups that historically have had less access to such resources. This can empower mothers from diverse backgrounds with the knowledge and confidence to breastfeed.
  • Cultural Competency in Care: Hospitals pursuing the BFHI designation are often encouraged to provide culturally competent care, which includes understanding and respecting the diverse cultural attitudes towards breastfeeding among different racial and ethnic groups.
  • Potential for Broader Health Benefits: Since breastfeeding is associated with numerous health benefits for both mothers and infants, increasing breastfeeding rates through BFHI can have broader implications for reducing health disparities. This includes lowering the risk of certain illnesses and chronic conditions that disproportionately affect racial and ethnic minority groups.

While the BFHI has potential to reduce disparities, it’s important to note that achieving equity in breastfeeding and maternal-infant health requires a multifaceted approach. This includes addressing broader social determinants of health such as access to healthcare, socioeconomic factors, and community support, alongside initiatives like BFHI. Research suggests that the Baby-Friendly Hospital Initiative can play a role in decreasing racial and ethnic disparities in breastfeeding and maternal-infant health care. However, it should be part of a broader strategy that addresses the complex factors contributing to these disparities.

References

There are several studies and publications that support the assertion that the Baby-Friendly Hospital Initiative (BFHI) can help in decreasing racial disparities in healthcare, particularly in the context of breastfeeding rates and maternal-infant health care.

These studies and reports underscore the role of the Baby-Friendly Hospital Initiative in potentially reducing racial disparities in healthcare, particularly in the area of breastfeeding and maternal-infant care. The BFHI’s focus on promoting breastfeeding and supporting all mothers regardless of racial or ethnic background contributes to its effectiveness in addressing these disparities.