'Baby-friendly' hospital initiative may not improve breastfeeding rates

First-ever evaluation of the effort finds "inconclusive evidence" that the program works
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The push to make hospitals more "baby-friendly" may not be going as intended, according to a new study published in the Journal of Midwifery & Women's Health.

The study found inconclusive evidence as to whether the program has actually led to greater rates of breastfeeding as originally planned. 

"I found a very mixed bag. Some studies show it does improve breastfeeding rates, others show it didn't have any impact, and some show that it has a negative impact," co-author Abigail Howe-Heyman, R.N., told Slate.com. "I'd say the bottom line is that it probably has some positive effect on breastfeeding outcomes, but not as much as we have been assuming it does."

The Baby-Friendly Hospital Initiative (BFHI) began as an outgrowth of a World Health Organization program designed to increase global rates of breastfeeding. In order to qualify for the program, hospitals must agree to adhere to a list of 10 rules including no pacifier use, elimination of their nurseries so babies stay in mothers' rooms and no infant formula unless it is medically necessary. 

The U.S. was a latecomer to the effort, only adopting the policy initiative in 2010 in some hospitals after the U.S. Department of Health and Human Services incorporated the initiative into federal goals. The Centers for Disease Control and Prevention offered millions of dollars in grants to hospitals that adopted the program.

Still, in 2015, studies found that hospitals are still falling short in their support for breastfeeding. Some 91 percent of hospitals offer instruction in breastfeeding, but only 26 percent make any effort to limit infant feedings with formula. The BFHI was meant to remedy that situation over time, but whether it is actually helping is difficult to determine.

Howe-Heyman told Slate that hospitals could be more mom-friendly by allowing the woman's partner to sleep in the room with the mother and child at no charge. She also suggests that lactation consultants avoid making new mothers feel pressured into breastfeeding. 

To learn more:
- read the Slate article
- read the study abstract

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