Down Under



I’m returning from Melbourne, Australia, where I was attending the International Lactation Consultant Association (ILCA) conference.  This year I had the honor and pleasure of speaking at one of the breakout workshop sessions.  The topic I was speaking on was breastfeeding and trauma; how emotional trauma including child sexual abuse and intimate partner violence can impact breastfeeding initiation and duration.  Tough topic, but necessary to address.

It was quite an experience to speak at a conference where some of the biggest names in breastfeeding gather.  Nils Bergman, Linda Smith and Liz Brooks were all among the headliners.  There is always so much to take away from these conferences.  New techniques to learn, new research to explore.  My inner geek lives for this stuff.  I would spend the day perched at the end of my seat, notebook and pen in hand, making plans on how to change the world.  

These conferences are so vast and versatile, there is something for everyone.  For me this year it was newborn behavior and the Baby Friendly Hospital Initiative.  Being that the conference was in Australia, the LC’s of Australia and New Zealand was in attendance, along with others from all over the world.  Astonishingly, every hospital in New Zealand except for 2 have the Baby Friendly designation, and every hospital in Tasmania is also part of this elite club.  Sweden has long since reached this goal, and is now looking for a new challenge.  

In the U.S., baby friendly hospitals are harder to come by.  If you aren’t familiar with the BFHI, it consists of 10 steps to follow these steps will earn your facility the baby friendly status.  Steps such as developing a breastfeeding policy, training staff, 24 hour mother/baby rooming in, and skin to skin are some of the guidelines.  Sounds easy enough – many hospitals are already doing this.  Until you get to that one step where the hospital gives up formula and commits to purchasing what is needed instead of accepting free formula.  Of course, if the hospitals start purchasing their own formula, they are likely to use less.  This is an extremely difficult step for hospitals, and can sometimes be the deal breaker.

Research over the last decade has shown that hospitals that have achieved baby friendly status have increased their breastfeeding rates; both breastfeeding initiation and duration.  In addition, hospitals that are just working towards implementing the 10 steps see higher breastfeeding initiation and less supplementation in the first 2 days.

Why isn’t every hospital working to improve maternity care practices by implementing the 10 steps?  It should be a group effort among health care providers and hospitals, Lactation Consultants and RN’s, and the families involved.  The families are, after all, the most important players in this game.  

By educating our parents about practices such as skin to skin, rooming in, and avoiding bottles in the early days, it will be easier for them to advocate for what is best for their baby and for themselves.  The information will give them the confidence to make their own decision.  Giving our new parents the knowledge should be the first real step in becoming baby friendly.


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