Published Apr 11, 2012
kms6417
26 Posts
Today our UPC group discussed starting the process in becoming a baby friendly hospital. We deliver over 4000 babies a yr. We have a great Lactation Department with IBLCE certified RN's. Can anyone give us some advise in getting staff on board with this. This is obviously going to be a real change in how we do things now. Changing our nursery setting to an area used only for hearing screenings and circs will be quite a transition for both staff and parents. We do Mother Baby care on our unit. Thanks
BuckyBadgerRN, ASN, RN
3,520 Posts
Ditch the formula bags and any giveaways sponsered BY formula companies! Educate, educate, educate. Unfortunately the vast majority of health care providers think formula is a safe/comparable alternative to breastmilk and it is proven that it's not. They need to understand that babies tiny tummies are EXPECTING mother's milk be prepared to promote that
melmarie23, MSN, RN
1,171 Posts
Get all RN trained in breastfeeding support. We took BCEP, and I also independtly took the CLC course. MDs, Midwives and Peditricians should also receive training. Have a formal breastfeeding policy. Look into having human donor milk on hand for supplementation purposes. Sign out the formula. Document why supplemetation was needed (this is separate from when a mom comes in and decides to formula feed from the get-go. Breastfed babies who need supplementation, that needs proper documentation). Encourage skin-2-skin immediately after birth. Try to get baby on breast within a half hour to an hour after birth...this goes for c-sections as well. Do not give out pacifiers.
Its a ton of education and selling at first, but once the steps are implemented it becomes routine/second nature.
Thanks! Those are some great suggestions for starting
LibraSunCNM, BSN, MSN, CNM
1,656 Posts
I second everything melmarie23 said. I work in M/B and we got BF certified in 2010. Our formula is in an OmniCell, like the narcotics, so that we keep track of who gets it. Our hospital has held the CLC course several times in the last 2 years since we went BF, and almost all of our nurses are now CLCs, as well as some in L&D and NICU. We have formal written breastfeeding policies regarding skin to skin initiation after birth, breastfeeding assistance, teaching moms to manually express, and supplementation. The hardest part has been getting the pediatricians, of all people, to support our endeavors. Many of them still routinely give out incorrect information about breastfeeding and formula. So annoying.
Thanks for your info. I am a bit perplexted on how a Late Preterm infant falls into all of this. We have a very detailed admission order set for these infants and supplementation with formula is part of it. What do you do with a 35 wker who does not effectively nurse, mom is pumping and getting nothing?
human donor milk (if mom consents) or formula if what they pump isnt enough.
Baby Friendly is not synonymous with "breast only." I think people often have that misconception. There are medical indications where supplementation is necessary and we recognize that and treat the infant accordingly.
babyktchr, BSN, RN
850 Posts
it is a common misconception yes, but i find more and more that it is being perpetuated, which is a shame.
klone, MSN, RN
14,856 Posts
Donor breastmilk, just like with the younger NICU babies.
Marymoomoo
101 Posts
It can be quite difficult to express colostrum by pump. Sometimes even after the milk becomes more plentiful, it can be difficult to express (or drain the breast well, at least) by pump alone.
Especially if a mom is breastfeeding or pumping for her premature infant, she should be taught hand expression and hands on pumping. Are you familiar with the research by Morton et al? This video touches on the preliminary results: Maximizing Production - Newborn Nursery at LPCH - Stanford University School of Medicine
carrie_c
235 Posts
I guess I'm a little confused. What about the moms who don't want to breastfeed? Would they not be allowed to have their babies at your hospital?