UNM Hospital recently became the first hospital in the Albuquerque area to win a prestigious national designation as a baby-friendly birth facility.
The award from Baby-Friendly USA, Inc. recognizes birth facilities that offer breastfeeding mothers the information, confidence and skills needed to successfully initiate and continue breastfeeding.
Baby-Friendly USA, Inc., is the U.S. accrediting body charged with implementing the Baby-Friendly Hospital Initiative, a global program sponsored by the World Health Organization and the United Nations International Children’s Fund. There are 215 active Baby-Friendly hospitals and birth centers in the U.S., with more than 20,000 worldwide.
To qualify as “Baby-Friendly,” a hospital must demonstrate that it has implemented 10 evidence-based practices that support breastfeeding. UNMH staff members and physicians received more than 20 hours of training in the practices and a stringent on-campus hospital assessment was held, says Michelle Wafer, RN, executive director for women's services.
“It takes an important culture shift for a hospital to be able to meet Baby-Friendly criteria,” Wafer says.
"Science has shown that breastfeeding offers a wealth of benefits to both infants and their mothers,” says Emilie Sebesta, MD, associate professor in the Department of Pediatrics and pediatric medical director of the Mother-Baby Unit. “These benefits extend well beyond infancy, yet for much of the past 100 years in the United States, mothers were either directly or implicitly encouraged to feed their babies formula.”
The longstanding practice of sending new mothers home with free bottles of infant formula sends an unspoken message, Sebesta says.
“We’ve always said to the mothers, ‘It’s your choice,’” Sebesta says, “but if you are saying that as you are sending bottles of formula with them from the hospital then in a very subtle way you are saying, ‘You are going to need to use this.’”
A multi-year reform effort led to the recent award. In 2010, Sebesta decided that the hospital needed to transform its practices and pursue a “Baby-Friendly” designation. She was surprised by the enthusiasm with which her proposal was met.
“A number of people in different areas had been wanting to do this for some time and we just weren’t aware of who else was out there,” Wafer says. A multi-disciplinary group was convened and UNMH officially entered the Baby-Friendly 4-D Pathway that summer. "We thought we were doing a number of things well,” she adds, “but we knew we would still have to change many of our newborn guidelines. And, we soon learned that even things we thought we were doing well could be done better.”
For instance, she says, the hospital promoted the practice of allowing newborns to “room-in” with their mothers, but it still routinely separated healthy newborns from their mothers in order to allow nurses and doctors to do their initial assessments. Babies were placed under warmers to ensure that their body temperatures remained stable, then bathed and put back under the warmer to get warm again.
“Now, babies go straight to the room with their mothers and are assessed on or beside their mothers,” Wafer says. “The bath is delayed until the baby is a little older and can better handle the stress. Afterwards, babies are placed back skin-to-skin with their mothers to ensure they don’t get too cold. Everyone is happier. Babies cry less. Parents get to watch or give their baby his or her first bath. And, nurses do not spend time trying to get babies warm again after their baths.”
To meet the Baby-Friendly guidelines, the hospital also had to show that it supports hospital staff who are nursing their own children. That required placing pump rooms throughout the hospital system, said Andrea Petitto, RNC, unit director for the hospital’s Mother Baby Unit, Newborn Nursery, Lactation Education Services and Newborn Clinic.
“We find that our families have heard a lot about breastfeeding and want to learn more,” she says. “They know that breastfeeding leads to healthier families.”
Mother Nature had it right all along, adds certified nurse midwife Laura Migliaccio, the hospital’s chief of midwifery. “Most women are able to do this, yet more than half don't believe they can make enough breast milk to be successful. They need our encouragement and support. Now, with Baby-Friendly, they'll get it."