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| No. 10 | 
Nov 08, 2009, 07:57 PM
Updated
Nov 08, 2009 at 08:04 PM by nurturing_angel
 Re: Are "Baby Friendly" hospitals dishonoring cultural diversity
I don't work in a "baby-friendly" hospital. We do provide formula for mothers who request it. I am a huge fan of breast feeding and I know that breast is best. But what about mothers that want to bottle feed? What about their rights to choose how they want to feed their babies?
Are these mothers allowed to bring their own formula to the hospital so they can feed their babies? Or if they want to bottle feed, do they just find a alternate hospital to deliver?
Just wondering?   | | Advertisement Sponsored Links | | | | No. 11 |
Nov 08, 2009, 08:20 PM
Re: Are "Baby Friendly" hospitals dishonoring cultural diversity I am not too familiar with baby friendly hospitals, but it is my understanding that they only give formula on very rare occasions such as a sick baby.
That's not how I understand it. http://www.babyfriendlyusa.org/eng/10steps.html The Ten Steps To Successful Breastfeeding
The BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States are: 1 - Maintain a written breastfeeding policy that is routinely communicated to all health care staff. 2 - Train all health care staff in skills necessary to implement this policy. 3 - Inform all pregnant women about the benefits and management of breastfeeding. 4 - Help mothers initiate breastfeeding within one hour of birth. 5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants. 6 - Give infants no food or drink other than breastmilk, unless medically indicated. 7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day. 8 - Encourage unrestricted breastfeeding. 9 - Give no pacifiers or artificial nipples to breastfeeding infants. 10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic 
I think that it would definitely be indicated if the mother was not breastfeeding. I would imagine that a parent could request it if they were both bottle and breastfeeding. It just would not be routinely stocked in every baby's bed like it is at the hospital I'm doing clinicals in right now. It's my understanding that BFI hospitals still stock formula, but they have to pay for it, rather than getting it gratis from formula companies.
| | No. 13 |
Nov 09, 2009, 12:13 AM
Re: Are "Baby Friendly" hospitals dishonoring cultural diversity Originally Posted by HeartsOpenWide  I am not too familiar with baby friendly hospitals, but it is my understanding that they only give formula on very rare occasions such as a sick baby. But what about respecting different cultures? A large majority of Hispanic women breast and bottle feed. Some American Indians believe that colostrum is dangerous to baby and will bottle feed until milk comes in, there are many other cultures that have different beliefs on breastfeeding than what Baby Friendly hospitals would "allow" ( http://www.cdph.ca.gov/programs/Brea...scriptions.pdf). How do Baby Friendly hospitals honor other cultures?
I totally agree that we all should be striving to be understanding of and accomodating towards one another's cultures. I must say, though, that I found the information provided in the link borderline offensive. There are hundreds of different cultures within the classification of "American Indian" , dozens or more within "Hispanic" or "Asian", etc., and not one set of ideals fits all. I would guess that the information could be helpful to someone who was unknowlegeable of the range of beliefs one might find in other cultures, but I don't think the document is by any means an accurate representation of the variety of ideals and beliefs you are likely to find within any one racial group.
The BFHI rules aren't so rigid as to not allow room for mothers who have cultural beliefs about breastfeeding in the early days, or who choose to formula feed for personal reasons. To qualify for BF status, you need at least 75% of all mothers exclusively breastfeeding OR formula feeding for medical reasons at discharge. There is certainly room there for mothers who will formula feed by choice (including cultural beliefs). BFHI rules don't allow for formula advertising, formula "freebies", or anything that might influence mothers to use formula. Mothers that choose to feed formula are educated about the risks and benefits of various feeding options, and are educated about what is affordable, feasible, accessable, sustainable, and safe in the own unique situations. ALL mothers that formula feed (regardless of reason) are educated about how to properly and safely mix, feed, and store formula.
You can read more about the BFHI guidelines here: http://www.who.int/nutrition/publica.../en/index.html (open the PDF for detailed info) http://www.who.int/nutrition/topics/bfhi/en/index.html (info from WHO) http://www.babyfriendlyusa.org/
All that being said, I would think that even if a mother is choosing formula for cultural reasons, she should be given accurate information so that she can truly make an informed decision. It doesn't seem right to avoid giving a woman information that could benefit her child (and herself!) for ANY reason. All women deserve to be able to make informed choices about their own care and the care of their babies.
| | No. 14 |
Nov 09, 2009, 01:06 AM
Re: Are "Baby Friendly" hospitals dishonoring cultural diversity
My OB unit is designated "baby-friendly" and I don't think that we practice any differently than any other OB unit. The 10 steps that designate a "baby-friendly" facility are: 1. Maintain a written breastfeeding
policy that is routinely communicated
to all health care staff.
2. Train all health care staff in skills
necessary to implement this policy.
3. Inform all pregnant women about the
benefits and management of
breastfeeding.
4. Help mothers initiate breastfeeding
within one hour of birth.
5. Show mothers how to breastfeed and
how to maintain lactation, even if they are separated from their infants.
6. Give infants no food or drink other
than breastmilk, unless medically
indicated.
7. Practice “rooming in”-- allow mothers
and infants to remain together 24
hours a day.
8. Encourage unrestricted breastfeeding.
9. Give no pacifiers or artificial nipples
to breastfeeding infants.
10. Foster the establishment of
breastfeeding support groups and
refer mothers to them on discharge from the hospital or clinic.
We don't withhold or discourage formula feeding. It's more about giving women the tools and support they need to breastfeed.
| | No. 17 |
Nov 09, 2009, 12:59 PM
Updated
Nov 10, 2009 at 06:34 PM by rn/writer
Re: Are "Baby Friendly" hospitals dishonoring cultural diversity Originally Posted by Barkow My main issue with the baby friendly hospital concept is that the decision to breast or bottle feed is something that one should be formulating during their entire pregnancy, not just their time in the hospital. Until we have a baby friendly society and baby friendly OB docs who encourage breastfeeding and make it a priority, having a baby friendly hospital isn't making the intended impact.
I couldn't agree more!
The time for a woman to be considering her options and making a decision (and a commitment) is during the pregnancy when there is time for education and support from her doc and all the other staff members at the office or clinic where she is receiving care. It is NOT during the middle of the night after hours of pushing or a c-section (or for some poor women, both!) when she is exhausted, and the baby is starving and won't latch easily.
The ideal would be for lactation consultants to be meeting with patients several times before delivery. This would be a real boon in connection with low-income clinics where there are many very young moms who may not have the motivation or support they need unless the idea of breastfeeding is started early and encouraged throughout the pregnancy.
Postpartum floor nurses should be the icing on the cake, reinforcing and building on what has taken place in the six months prior. When we are the ones just planting the seed after delivery, it's tremendously unrealistic to expect us to reap a good harvest in the short time we have to work. We try our best, but I'm sure the results would be much better if the education had started months earlier.
Truly baby friendly programs would include an ongoing effort from the first OB appointment through the first three months--or longer--of care. This could start in the OB's office (or with a referral to lactation resources at the hospital) and continue with support groups after the birth.
But the question always ends up being, "Who's going to pay for this?" Unfortunately, we know the answer to who will pay if there are no such services.
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