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Breastfeeding-Friendly Hospitals: How Three States Are Making it Happen

When it comes to breastfeeding and its health benefits for moms and babies, "“You can’t overstate the impact hospitals have,” said Dr. Paula Schreck, a pediatrician in Detroit who serves as breastfeeding coordinator at St. John Providence Health System, and as medical director of St. John Outpatient Breastfeeding Clinic in the city. She's also the organizer behind Michigan's MotherBaby Summit, which was held this past Thursday, and included doctors, nurses, lactation consultants, hospital administrators and others from the hospital community across the state, all sharing best-practices and strategic success stories for developing hospital policies that best serve moms and babies by encouraging breastfeeding. Allowing moms and babies to "room in" together post-delivery, for example, has been shown to make a big difference in long-term breastfeeding success, as have the other nine steps outlined in the Baby-Friendly Hospital Initiative, which was outlined in the 1990s by Unicef and the World Health Organization, but today, over a decade later, is still very much in need of widespread implementation in America's hospitals.

Why are hospitals such a big deal when it comes to breastfeeding? Well, as I wrote on this blog in June, "although many moms plan to exclusively breastfeed their babies for at least three months, only a third of those moms succeed in doing so. [A recent] Pediatrics study showed that the most statistically relevant factor in this equation was whether babies received supplemental formula while still in the hospital." As Dr. Schreck and others at the summit discussed, hospitals play a vital role in setting the stage for breastfeeding success by -- ideally -- helping moms and babies establish a solid foundation in the days before they're discharged. As controversial as ditching corporate-sponsored, free-formula goody bags may be -- something that Massachussetts, the first state to hold a MotherBaby summit like last week's in Michigan, has committed to state-wide -- and as much as the media ripped into the recently-launched Latch On NYC initiative in New York, there is solid evidence that in-hospital support counts. For a lot. Efforts like these add up to more breastfed babies, which adds up to healthier populations.

“Making breastfeeding the easy choice benefits families, and in the long run, makes our state stronger,” Dr. Schreck said. Both points are apt, and it's exciting to see something like the MotherBaby Summit take place in Detroit, of all places. (Massachusetts hosted its fourth summit this year, in addition to helping launch events in Michigan and Pennsylvania.) As a representative from the W.K. Kellogg Foundation, which provides funding for the program, said, "We are concerned about the most vulnerable children in our society… We are working with communities in Michigan to help give children the best opportunities for a healthy start, and to promote efforts like breastfeeding, that can help mitigate poor health outcomes.” Michigan is the 5th most obese state in the country, and is expected to spend $12.5 billion on obesity-related health care in 2018. Diabetes, and other health problems, are pervasive. Focusing on giving a population whose kids face some pretty dismal health related odds a policy-backed jump-start by creating a breastfeeding-supportive hospital system is a smart place to begin when it comes to reversing some of the more unfortunate health related trends afflicting that population. The AAPs new breastfeeding recommendations are backed by science; breastfeeding benefits kids' health in the first year of life and into the future, helping to control or mitigate just the kinds of health problems Michigan's -- and America's -- populations now contend with on a broad scale (obesity included). And the strategic info-sharing going on at the summit was backed by what's really working, on the ground, in hospital birthing centers (a forward-thinking concept in itself) across Michigan, so the hospitals newly adopting some of these strategies have successful models to work from. Because -- it's a cliche for a reason -- why re-invent the wheel?

The MotherBaby Summit model is also promising because, as your comments consistently indicate when I write about hospital birth, or in-hospital breastfeeding support, women have drastically different experiences from hospital to hospital; I've written before about my own (kind of awful) post-delivery hospital stay in New York, but friends of mine who gave birth in the same city have described entirely different experiences in different institutions -- some good, some bad, but all for different reasons. Summits like those now held in Massachusetts, Michigan and Pennsylvania will help to establish some consistency between hospitals across those states, ensuring more moms overall score effective breastfeeding support before discharge. That these efforts are being inititiated and carried out by medical professionals within the hospital birth system, too, bodes well for their longevity, and suggests a positive, health-centric (rather than corporate-centric) sea change among hospital birth systems. 

Of course, successful breastfeeding and its requirements extend far beyond in-hospital support. Many women stop breastfeeding several days, weeks, or months after they've been discharged, and the AAP's guidelines specifically identify pediatricians, workplaces, and other social structures, in addition to hospitals, as crucial components of a larger, successful-breastfeeding picture. Remember this enlightening Motherlode post, on the true costs of breastfeeding? The building blocks of breastfeeding success, and its inherent logistical challenges, are not equally available to all women; working-class moms in particular-- like many of those giving birth in Michigan -- encounter unique difficulties in attempting to make breastfeeding work. As KJ Dell'Antonia wrote, "We need to support breast-feeding by putting in place laws, policies, programs and social structures that make [breastfeeding] easier, rather than attempt to gloss over its hidden costs. Breast milk isn’t free. But it’s within our power to make it affordable for all." The MotherBaby Summit in Detroit is a fantastic start, and absolutely the appropriate beginning-place, for the kind of policy, program-based, and structural changes that will make for better breastfeeding rates in Michigan; if moms leave the hospital with the solid breastfeeding foundation summit attendees hope hospitals will help them establish, they're definitely more likely to stick with it than if they leave without that positive start. But if they really are going to stick with it, it'll be because they step out onto solid, supported ground after they're discharged, too. Policies, programs and changing social attitudes are, indeed, very much in order. The good news is that if Michigan -- as a state currently facing significant challenges -- can find a way to build a breastfeeding-friendly 'system,' from its hospitals forward (and I think the recent summit is a sure sign that it can), then every other state can do it, too. Of course creating political and social change happens one step at a time, but every step along the will provide examples and 'best practices' -- like those shared at the summit -- for other states to work from.

Imagine if every state held an annual summit among its hospital birth community with the goal of putting the WHO/Unicef Baby-Friendly initiative into place! I think we're moving in that direction… do you?