Health Care

STEP 3, 5, & 7:  Optimal chest/breastfeeding is supported by health care in the community is breastfeeding friendly…healthcare clinics/offices follow the principles of the International Code of Marketing of Breast-Milk Substitutes…optimal chest/breastfeeding is defined as: Children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first six months of life…From the age of six months, children should begin eating safe and adequate complementary foods while continuing to breastfeed for 1 to 2 years and beyond.

Ten Steps to a Breastfeeding Family Friendly Community, Self-Appraisal: Approaches and Measures

Health care within the community must be breastfeeding friendly if a community is to support chest/breastfeeding families. Research confirms that comprehensive breastfeeding support in prenatal, maternity, and postnatal care results in improved breastfeeding success.

  • All maternity care centers are either designated Baby-friendly (BF) (or designated as fully qualified by their state maternity care breastfeeding designation) or a state-level designation. This designation must include at least the following: Healthcare personnel involved in the care of mothers and babies are trained in the skills necessary to support optimal breastfeeding. 
  • All clinics have been informed about the new BF Clinic/Office designation (e.g., see NCBC website), and at least 50% of offices have applied for the designation, OR, offices provide documentation concerning the prenatal breastfeeding support, such as educational tools, or practice behaviors, that they employ with every patient, regardless of race or ethnicity.
  • Parents will receive breastfeeding education and support from the healthcare facilities.
  • Healthcare facilities will not promote commercial infant or related toddler formula through ads or free samples and, when supplementation is medically-indicated, will make every effort to provide expressed milk from parent or donor human milk before infant formula.

Required Practices for Health Service Providers: 

  • Chest/breastfeeding families are always welcome and respected. They will never be treated poorly, asked to stop breastfeeding, or asked to cover up or move.
  • We do not promote or provide infant formula (including toddler formula), coupons, or related products unless medically indicated. We do not accept gifts of infant feeding products from manufacturers nor display infant feeding products.
  • We have a breastfeeding, chestfeeding, and human milk feeding policy. The policy includes sections for patient, provider and staff education; advice/telephone triage with a response time within 4 hours; and dispensing formula.
  • All lactating employees are allowed breaks to express milk or nurse their children and access to a private space for expressing milk or nursing. The space is not a bathroom; is lockable and shielded from view; includes an electrical outlet, and has hand hygiene available.
  • We adhere to the chest/breastfeeding practice advice of the breastfeeding expert opinions of our respective professional associations/colleges and/or the Academy of Breastfeeding Medicine.

Additional Required Practices for Obstetrics, Pediatrics, Family Medicine, and Med-Peds: 

  • The majority of our staff providing clinical services for prenatal and/or postpartum mothers and infants have had at least 3 hours of clinical breastfeeding support training. 
  • We have an IBCLC in our practice and/or we actively refer all prenatal and postpartum patients to skilled providers.
  • (If your practice provides prenatal services) We actively ensure that all prenatal patients receive interactive education on breastfeeding, as well as local support groups/healthcare information.

Suggested Approaches for BFFC Team:

  • Collaborate with local WIC, breastfeeding organizations, or health care organizations to make available breastfeeding materials and trainings.
  • Encourage all healthcare providers to attend the Carolina Global Breastfeeding Institute’s Breastfeeding University.
  • Work with a State-level-equivalent designation team. If there is no local designation process, this may be achieved initially by documentation that 80% of local health care providers have completed an existing on-line study or direct training, and documentation of this is provided to the team.
  • Encourage all hospitals and birth centers to seek the Baby-Friendly Hospital designation.
  • Hold at least one in-person or virtual meeting. Your team may facilitate the first meeting.
  • Confirm that breastfeeding-friendly health care services are active or being created that would serve the community, with attention to meeting the needs of various racial/ethnic groups.
  • Continue to provide encouragement and support to healthcare providers to meet expectations. Change may take time, and you may find your approach to change as you get to know your health care community. 

Resources for Healthcare Providers

Training and Education 



  • Drugs and Lactation Database, LactMed (National Center for Biotechnology Information, U.S. National Library of Medicine Book Shelf) The LactMed® database contains information on drugs and other chemicals to which breastfeeding mothers may be exposed. It includes information on the levels of such substances in breast milk and infant blood, and the possible adverse effects in the nursing infant. Suggested therapeutic alternatives to those drugs are provided, where appropriate. All data are derived from the scientific literature and fully referenced. A peer review panel reviews the data to assure scientific validity and currency.
  • Infant Risk Center: Breastfeeding (Dr. Thomas Hale’s site) Each year millions of pregnant and breastfeeding mothers use medications for an enormous variety of conditions and diseases. Many times – in fact most times – we may not know a lot about the use of these drugs in pregnancy or in breastfeeding. The InfantRisk Center is going to initiate a major program to discover the impact of using medications during pregnancy and during breastfeeding.
  • Mother to Baby (meds during pregnancy and breastfeeding), a service of the non-profit Organization of Teratology Information Specialists, is dedicated to providing evidence-based information to mothers, health care professionals, and the general public about medications and other exposures during pregnancy and while breastfeeding. Talk directly to the experts behind the most up-to-date research.

Inducing Lactation and Relactation