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Pick Low Hanging Fruit First
Those working towards the Baby-Friendly Hospital Initiative often find it is a complex, sometimes harder road, than they anticipated. Picking some of the easy “low hanging fruit” and getting some early successes can help the staff working on this project move forward with enthusiasm.
Implementing skin-to-skin care (Step 4) as one of the first strategies often does not meet with much resistance, and can yield impressive results in initiation of breastfeeding and patient satisfaction scores. McKeever found that infants in skin-to-skin care did not become hypothermic, most breastfed within an hour and they continued to successfully breastfeed the second day. In addition mothers remarked on the bonding effects (McKeever). Mothers who did not experience immediate skin-to-skin care demonstrated more roughness in their behaviors with their infants, difficulty with latch-on and infants showed a lack of wakefulness during breastfeeding (Dumas).
Easier to implement steps may include Step 3 (inform pregnant women about breastfeeding), and Step 5 (show mothers how to breastfeed), and Step 8 (encourage breastfeeding on demand). Provide breastfeeding information in childbirth and lactation classes. Encourage prenatal clinics and offices to recommend breastfeeding to their clients. Hospital staff is already showing mothers how to position and latch-on babies. Technique can be improved to be more effective through staff education. And flexibility in feeding schedules is probably in place, but can be encouraged. So start with these steps, then tackle the more difficult ones: Step 1 (breastfeeding policy), Step 6 (give nothing but breastmilk) and Step 7 (rooming-in) (Semenic).
Most managers implementing Baby-Friendly practices find that a gradual and step-wise approach works best. Make the most of the “easy to change behaviors” to get some momentum going and the rest will follow, eventually.
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Dumas L, Lepage M, Bystrove K, et al. The influence of skin to skin contact and rooming-in on early mother-infant interaction: A randomized control trial. Clin Nurs Res. August 2013;22(3):310-336.
McKeever J, St Fleur R. Overcoming barriers to baby-friendly status. J Hum Lact. Aug 2012:28(3):312-314.
Semenic S, Childerhose JE, Lauzière J, Groleau D.Barriers, facilitators, and recommendations related to implementing the Baby-Friendly Initiative (BFI): an integrative review. J Hum Lact. 2012 Aug;28(3):317-34.